| Objectives:In order to improve the filtration effect of bacterial filters for clinical inhalation and reduce the inhalation of aerosols by nurses during inhalation operation,the bacterial filters were therefore improved,and the use of the improved bacterial filters by patients with respiratory diseases was analyzed and evaluated to provide evidence to support the clinical promotion of the improved bacterial filters.Methods:Step 1: Two new bacterial filters were obtained by optimizing the appearance structure and internal filtration material of the existing bacterial filter（named A filter）,and the physical objects were obtained by CAD modeling through 3D printing named B filter and C filter,respectively.Step 2: The inhalation exposure rate and bacterial filtration efficiency of nurses when the nebulizer was used with the modified bacterial filter were tested experimentally,in the spirit of In the spirit of ethical harmlessness and the limitations of experimental technology,this part of the experiment was conducted in a laboratory simulation study,using a dust particle counter to measure the number of inhaled aerosol particles of different particle sizes and a bacterial dish to count the number of bacteria before and after filtration.Step 3: Evaluate the specific situation of clinical patients after using the modified bacterial filter,and determine whether the modified bacterial filter has the potential for clinical extension.A total of 75 patients with stable bacterial pneumonia in the Department of Respiratory and Critical Care at the First Hospital of Jilin University from March2021 to December 2021 were collected for the study,and the changes of general vital signs,oxygen saturation and comfort were observed and recorded when the patients used A,B and C filters,respectively,during inhalation therapy.The patients all made the WY10-A adult population with mouth medical nebulizer produced by Wuhan Zhixun Chuangyuan Science and Technology Development Co.,Ltd.to nebulized with oxygen flow rate of 4L/min and 8L/min respectively,the solution was 10 ml of saline,the time was 15 minutes,before each nebulization,nebulizing for 5 minutes,nebulizing for 15 minutes to record the patients’ body temperature,respiration,pulse rate,blood pressure,etc.respectively vital signs and blood oxygen saturation,and nebulization comfort was recorded at the end of nebulization.A database was established and data analysis was performed using the IBM.SPSS.Statistics24.0Results:1.After using A,B and C bacterial filters during nebulized inhalation therapy,the difference between the inhalation rate of nurses was statistically significant（P <0.001）,and the inhalation rate of C filter was lower than that of B filter lower than that of A filter by LSD two-by-two comparison（P < 0.05）.2.There was no statistically significant difference in bacterial filtration efficiency between the three groups when A,B and C bacterial filters were used for nebulized inhalation treatment（P > 0.05）.3.In the pre-experiment,patients had significant wheezing discomfort when using B bacterial filter and abandoned the clinical experiment.4.During nebulization at a flow rate of 4L/min,the differences in body temperature,respiratory rate,pulse rate and blood pressure of patients at the same time（5 minutes of treatment and 15 minutes of treatment）when using A and C bacterial filters were not statistically significant（P > 0.05）and were within the normal range.During nebulization at a flow rate of 8L/min,the differences in body temperature,respiratory rate,pulse rate,and blood pressure of patients at the same time（5 minutes and 15 minutes of treatment）with both A and C bacterial filters were not statistically significant（P > 0.05）and were within the normal range.5.During nebulization at a flow rate of 4L/min,the differences in oxygen saturation of patients at the same time（5 minutes of treatment and 15 minutes of treatment）with both A and C bacterial filters were not statistically significant（P > 0.05）and were within the normal range.During nebulization at a flow rate of 8L/min,the difference in oxygen saturation of patients at the same time（5 minutes of treatment and 15 minutes of treatment）with both A and C bacterial filters was not statistically significant（P > 0.05）and was within the normal range.6.During nebulization at a flow rate of 4 L/min,the differences in nasopharyngeal discomfort,lower respiratory tract sensation,irritating choking and breath-holding of the patients when using the two bacterial filters A and C were compared with all P >0.05 and were not statistically significant;during nebulization at a flow rate of 8L/min,the differences in nasopharyngeal discomfort,lower respiratory tract sensation,irritating choking and breath-holding of the patients were compared with all P >0.05,also not statistically significant.Conclusions:1.Obtain B filter by upgrading A filter material grade from G4 to F9;obtain C filter by upgrading A filter material grade from G4 to F9,optimizing the structure to funnel type and adding activated carbon.2.Compared with A bacterial filter,the use of B and C bacterial filters during nebulized inhalation can further effectively reduce the aerosol inhalation rate of nurses,and C is better than B,that is,the improvement is effective.3.Compared with A bacterial filter,the use of B and C bacterial filters during nebulized inhalation can also effectively filter bacterial microorganisms in aerosols,and the filtration effect is >95% for both.4.Compared with A bacterial filter,patients will have obvious discomfort symptoms when using B bacterial filter,so B bacterial filter is not suitable for clinical use;patients have no obvious discomfort symptoms when using C bacterial filter,so C bacterial filter can be promoted to clinical use. |
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