综合护理措施预防呼吸机相关性肺炎的效果  

Effect of comprehensive nursing countermeasures on prevention of ventilator-associated pneumonia

作　　者：叶惠燕[1] 丁晔[1] 马颖君[1] 孙维敏[1] 

机构地区：[1]无锡市人民医院神经外科,江苏无锡214023

出　　处：《中华医院感染学杂志》2012年第19期4231-4232,共2页Chinese Journal of Nosocomiology

摘　　要：目的评价综合护理措施预防呼吸机相关性肺炎(VAP)的效果。方法将预期接受机械通气>48h者分为综合护理预防组(A组)、常规气管导管组(B组),A组采用半卧位+口腔护理+置予声门下分泌物引流气管导管且每隔2h行声门下分泌物引流(SSD)+胸部护理+使用超过幽门的鼻十二指肠管作鼻饲,B组采用半卧位+口腔护理+常规气管导管,比较两组患者的住院时间、住ICU时间、机械通气时间、VAP发生率及相对危险度。结果 A组患者住院时间、ICU内住院时间、机械通气时间均短于组B组,A组与B组VAP发生率为34.1%和66.7%,早发性VAP发生率为7.3%和24.2%,差异有统计学意义(P<0.05)。结论实施综合护理措施可降低VAP发生率。OBJECTIVE To assess the effect of comprehensive nursing measures on the prevention of ventilator-associated pneumonia（VAP）.METHODS The patients who underwent expected mechanical ventilation with more than 48 h were randomly assigned to the comprehensive nursing prevention group（group A） and routine endotracheal catheter（group B）,group A adopted semi-recumbent plus oral nursing plus inserting endotracheal tube with subglottic secretions drainage for subglottic secretions drainage（SSD） at 2 h intervals plus chest nursing plus nasal feeding using nasoduodenal tube,and group B received semi-recumbent plus oral nursing plus routine endotracheal catheter,the duration of mechanical ventilation,length of ICU and hospital stay,the incidence of VAP and relative risk were compared.RESULTS Both the duration of mechanical ventilation and the length of ICU and hospital stay were less than those of group B,the incidence rates of VAP were 34.1% in group A and 66.7% in group B,the incidence rates of the early VAP were 7.3% and 24.2%,the differences were statistically significant（P0.05）.CONCLUSION The comprehensive nursing measures can reduce the incidence of VAP.

关 键 词：呼吸机相关性肺炎 护理 预防 

分 类 号：R181.32[医药卫生—流行病学]