针对性综合护理干预对降低呼吸机相关性肺炎的影响  

Influence of the pertinence integrated care intervention to reduce ventilator associated pneumonia

作　　者：方梅[1] 冯丽琴[1] 肖春莲[1] 罗利娜[1] 唐丽娟[1] 谭艳丽[1] 陈洁梅[1] 陈彩花[1] 

机构地区：[1]广东省深圳市宝安区人民医院ICU,518101

出　　处：《护理实践与研究》2011年第21期8-10,共3页Nursing Practice and Research

摘　　要：目的:探讨采取针对性综合护理干预措施对降低呼吸机相关性肺炎(VAP)的影响,以更进一步完善和提高人工气道管理技术,全面降低VAP的发生率和死亡率。方法:对我院2009年1月～2010年12月脑外科、呼吸科115例行人工气道机械通气(MV)的病人(设置为对照组)采取传统常规气道护理措施,对中心ICU的185例行人工气道机械通气(MV)的病人设置为实验组,实验组在常规护理的基础上选用一次性密闭式恒温湿化呼吸机管路系统、机械振动排痰、密闭式吸痰方式、专业给氧湿化,高质量口腔护理、集束化干预鼻饲营养等针对性护理干预措施。结果:实验组在病人机械通气时间、人工气道留置时间、痰液稀释程度、痰痂形成例数、痰量、VAP发生率和病死率方面明显优于对照组(P<0.05),差异具有统计学意义。结论:VAP发生的高危因素较多,但循证护理并采取针对性综合护理干预措施和先进的护理器具,对预防VAP的发生是积极有效的,可显著降低VAP的发生率和病死率,缩短住院时间,提升综合护理质量,提高病人满意度。Objective：To explore the influence of pertinence integrated care intervention to reduce ventilator-associated pneumonia（VAP）,to further refine and enhance the artificial Airway management technology,full lowering the incidence and mortality of VAP.Methods：In our hospital from 2009 January-2010 December brain surgery,respiratory department during 115 routine artificial airway mechanical ventilation（MV） of patients（set to the control group） taking traditional general airway nursing measures.On the center of the ICU 185 routine artificial airway mechanical ventilation（MV） of patients（Set to experiment group） in general care selection on the basis of a one-time hermetic moistened ventilator pipe system,mechanical vibration sputum,closed suction mode,the specialty gives the oxygen wet,high-quality dental care,cluster-based intervention nasogastric feeding nutrition focused nursing interventions.Result：The experimental group in mechanical ventilation time,artificial airway retention time,the degree of dilution,phlegm scab shape precedent number,sputum and phlegm,VAP incidence and mortality rate outgo control group,P0.05,difference statistically meaningful.Conclusion：VAP occur more risk factors,however,evidence-based care and to take targeted comprehensive nursing interventions and advanced care appliances,to prevent the occurrence of VAP is active and effective,may significantly reduce the incidence and mortality of VAP,reduction in hospital time,improve the quality of integrated care,Increase patient satisfaction.

关 键 词：呼吸机相关性肺炎 最佳湿化 管路 口腔护理质量 管饲营养干预 

分 类 号：R473[医药卫生—护理学]