呼吸机集束化护理在颅脑外科机械通气患者中的应用  

Application of ventilator cluster nursing for mechanically ventilated patients in Craniocerebral Department

作　　者：周玉华[1] 朱蔚仪[3] 许燕杏[4] 许美卿[2] 林丽[2] 洪蝶玟[1] 许海雄[2] 

机构地区：[1]广东省汕头市中心医院护理部,515031 [2]广东省汕头市中心医院神经外科,515031 [3]广东省汕头市中心医院呼吸科,515031 [4]广东省汕头市中心医院骨科,515031

出　　处：《中华现代护理杂志》2013年第4期405-407,共3页Chinese Journal of Modern Nursing

基　　金：2011年汕头市重点科技计划项目（汕府科[2011]46号）

摘　　要：目的探讨呼吸机集束化护理在颅脑外科机械通气患者中的应用效果。方法将2010年1月至2011年7月收住颅脑外科病房60例机械通气患者作为观察组，进行呼吸机集束化护理措施：抬高床头30—45°、消化性溃疡的预防、每日试停镇静药、深静脉血栓形成的预防、口腔护理、声门下分泌物吸引和手卫生。选择2008年6月至2009年12月同科室行机械通气58例患者作为对照组，采用常规的护理方法。比较两组患者呼吸机相关性肺炎（VAP）的发生率、机械通气时问、病死率。结果观察组患者VAP发生率为40．0％，机械通气时间为（189．7±64．5）h，病死率为25．O％，对照组分别为72．4％，（331．3±86．7）h，51．7％，差异有统计学意义（X^2／t值分别为12．571，10．089，8．928；P〈0．05）。结论颅脑外科行机械通气患者进行呼吸机集束化护理措施可减少VAP发生率、病死率和缩短机械通气时间。Objective To study the effect of ventilator cluster nursing in mechanically ventilated patients in Craniocerebral Department. Methods Totals of 60 cases of mechanically ventilated patients admitted during January 2010 to July 2011 in Craniocerebral Department wards were the experimental group, which received ventilator cluster nursing, including raising bed 30 -45°, prevention of peptic ulcer, trying to stop sedatives everyday, prevention of deep vein thrombosis, oral care, attraction of subglottic secretions and hand hygiene. A total of 58 cases of mechanically ventilated patients from June 2008 to December 2009 in the same department were the control group, receiving conventional methods of nursing. Incidence, duration of mechanical ventilation and mortality of ventilatorassociated pneumonia （VAP） in two groups were compared. Results The incidence, duration of mechanical ventilation and mortality of VAP were respectively 40.0% , （ 189.7 ± 64.5 ） h and 25.0% in the experimental group, 72.4%, （331.3 ± 86.7 ） h and 51.7% in the control group, and the differences were statistically significant （X^2/t = 12. 571,10. 089,8. 928, respectively; P 〈0. 05 ）. Conclusions Ventilator cluster nursing can reduce the incidence and mortality of VAP, as well as shorten the duration of mechanical ventilation in mechanically ventilated patients in Craniocerebral Department.

关 键 词：肺炎 呼吸机相关性 机械通气 集束化护理 

分 类 号：R473.6[医药卫生—护理学]