呼吸机相关性肺炎集束化护理方案预防的效果研究  

Effects of cluster nursing program for prevention of ventilator-associated pneumonia

作　　者：范晓华[1] 曹岳蓉[1] 徐娟[2] 徐晓娟[1] 

机构地区：[1]东南大学医学院附属江阴医院护理部,江苏江阴214400 [2]东南大学医学院附属江阴医院ICU,江苏江阴214400

出　　处：《中华医院感染学杂志》2015年第18期4203-4205,共3页Chinese Journal of Nosocomiology

基　　金：江苏省卫生厅重点学科基金项目(KF201207)

摘　　要：目的探究集束化护理方案在预防呼吸机相关性肺炎(VAP)的效果,为临床预防VAP提供科学指导。方法选取2012年1月-2014年1月在医院治疗的240例机械通气患者,随机分为对照组和试验组,每组各120例,对照组采用常规护理措施,试验组在对照组的基础上采用集束化方案进行护理干预,观察比较两组患者VAP发生率、ICU住院时间、机械通气时间、血气分析及痰病原学检查结果。结果试验组患者VAP发生率为15.0%,显著低于对照组的30.0%,差异有统计学意义(P<0.05);干预前两组患者氧分压(PaO2)、二氧化碳分压(PCO2)、心率(HR)差异均无统计学意义;两组患者干预后PaO2、PCO2、HR与干预前相比差异均有统计学意义(P<0.05);治疗后试验组患者的PaO2、PCO2水平分别为(87.28±13.44)(44.37±7.62)mm Hg,显著优于对照组的(77.32±12.11)(63.21±9.82)mm Hg,两组差异有统计学意义(P<0.05);试验组患者深部痰培养中检出病原菌51株,显著低于对照组检出的398株(P<0.05)。结论集束化护理方案可有效预防VAP的发生,降低患者感染率,改善患者的生存质量,对临床具有一定的指导意义,值得临床上推广运用。OBJECTIVE To explore the clinical effect of cluster nursing programs in the prevention of ventilator-associated pneumonia（VAP）,so as to provide scientific guidance for clinical prevention of VAP.METHODS Totally240 patients receiving mechanical ventilation during Jan.2012 to Jan.2014 were selected and randomly divided into the control group and the experimental group with 120 cases in each group.The control group used conventional nursing measures and the experimental group used the cluster scheme nursing intervention on the basis of the control group.Patients were observed and compared for the incidence of VAP,ICU length of stay,duration of mechanical ventilation,blood gas analysis as well as results of sputum pathogenic examination.RESULTS The incidence of VAP in the experimental group（15%）was significantly lower than that in the control group（30%）（P〈0.05）.Before intervention,the levels of PaO2,PCO2 and HR had no significant differences between the two groups.After intervention,the levels of PaO2,PCO2 and HR had significant differences compared with before intervention for both groups（P〈0.05）.After treatment,PaO2 and PCO2levels were（87.28±13.44）and（44.37±7.62）respectively in the experimental group,significantly better than（77.32±12.11）and（63.21±9.82）in the control group（P〈0.05）.Totally 51 pathogenic strains were detected as positive in the deep sputum culture in the experimental group,significantly lower than 398 pathogenic strains detected in the control group（P〈0.05）.CONCLUSIONThe cluster nursing program can effectively prevent the occurrence of VAP,reduce infection rates and improve the quality of life of patients,which has certain clinical significance,worthy of clinical promotion.

关 键 词：集束化方案 机械通气 呼吸机相关性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]