Clinical Application Research Of The Disposable Sputum Collection And Moisturizing Protective Cover In Post-tracheotomy Care

objective:The study applied the disposable sputum collection and moisturizing protective cover with two other kinds of clinical commonly used methods,to intervention the post-tracheotomy patients through randomized controlled clinical trials.To observation the respiratory function,endotracheal humidification,protection effect,evaluate the efficacy of protective cover,and supply information for clinical application.Methods:48 post-tracheotomy patients without mechanical ventilation were enrolled in the study,who were selected from the neurosurgical department of a top three hospital in southern Sichuan.Patients were selected according to the inclusion and exclusion criteria,and randomized to traditional group(n=16),experimental group(n=16),control group(n=16).The tracheotomy tube in traditional group were covered by 2 layers of damp sterile gauze,while experimental group used protective cover,control group used the heat and moisture exchanger(HME)for 7 days.Breathing rate(RR),Pulse Oxygen Saturation(SpO2),inspiratory temperature and humidity,expiratory temperature and humidity were recorded daily,arterial oxygen pressure and arterial carbon dioxide pressure were detected at day 0,day 1,day 4,day7;the incidence of Ⅲ degree phlegm,trachea hemorrhage,irritable cough,sputum scab formation and pulmonary infection;the incidence of wound infection and sputum contamination.Results:1.Respiratory function:there was no statistical significance in RR,SpO2,PaO2 and PaCO2 between three groups(P>0.05);2.Endotracheal humidification(1)Inspiratory temperature and humidity:inspiratory temperature in experimental group was higher than control group,the difference was statistically significant(P<0.05),control group was higher than that of the traditional group(P<0.001),inspiratory humidity in experimental group was lower than control group,but higher than traditional group,the difference was statistically significant(P<0.001),(2)Expiratory temperature and humidity:there was no significant differences in the expiratory temperature(P>0.05),and no significant difference in the expiratory humidity between experimental group and control group,which both higher than that of traditional group(P<0.001),(3)Viscosity sputum:There was no incidence of III degree phlegm in both experimental group and control group in 7 days,which was significantly lower than that of control(P<0.05),(4)Deficient humidification:The incidence rate of trachea hemorrhage,irritable cough,sputum scab formation in experimental group and control group is lower than control,but which was not statistically significant(P>0.05),among the three groups and the pulmonary infection rate was no significant difference(P>0.05);3.Protection effect(1)Sputum contamination:There was no sputum contamination in both experimental group and control group,which was significantly lower than the traditional group(P<0.05),(2)Wound infection:The severity of wound infection in experimental group was lower than traditional group(P<0.05),control group was lower than traditional group(P<0.05),the difference between experimental group and control group was not statistically significant(P>0.05),while the incidence rate of wound infection in three groups was not statistically significant(P>0.05).Conclusion:1.The protective cover had no significant effect on patients’ respiratory function;2.Protective cover could adjust the temperature and humidity while inspiratory and expiratory;the protective cover decreased the viscosity sputum,and had a declining trend in deficient humidification,a longer time observation was still needed to evaluate the practical effects;3.Protective cover could effectively prevent the sputum contamination,reduce the severity of wound infection,but the incidence rate of wound infection in three groups was not significantly difference.