集束化干预措施对呼吸机相关肺炎的防治效果研究  

Analysis of the preventive effect of cluster intervening measures on the ventilator associated pneumonia

作　　者：郭金玲[1] 张长春[1] 贾晓君[1] 张淑敏[1] 焦涛[1] 

机构地区：[1]中国人民解放军第306医院重症监护室,北京100101

出　　处：《临床急诊杂志》2016年第3期230-232,共3页Journal of Clinical Emergency

摘　　要：目的:探讨呼吸机相关肺炎(VAP)集束化干预措施对ICU患者的防治效果。方法:选取2014-01-2015-06入住我院ICU的机械通气患者89例作为干预组,在常规治疗护理的基础上给予集束化干预措施。将2012-06-2013-12未实行集束化干预措施的机械通气患者106例作为对照组。采用回顾性调查方法,查阅有创机械通气患者的病例资料,并逐项填写统计表。观察比较2组患者机械通气时间、住院时间、VAP发病率及病死率。结果:干预组患者机械通气时间、住院时间均显著短于对照组[(11.4±2.2)d vs.(16.3±3.1)d,(12.5±4.4)d vs.(17.8±5.2)d,P<0.05];干预后,干预组患者VAP发生率14.6%(13/89),VAP病死率30.8%(4/13),对照组患者VAP发生率36.8%(39/106),VAP病死率为43.6%(17/39)。干预组VAP发生率显著低于对照组(P<0.01),但2组VAP病死率比较差异无统计学意义。结论:采取集束化干预措施可以降低VAP的发生率。Objective：To investigate the preventive effect of cluster intervening measures in ICU patients of ventilator associated pneumonia.Method：Eighty-nine cases of patients with mechanical ventilation in ICU of our hospital from January 2014 to June 2015 were selected as intervention group.All the paitents were given cluster intervening measures on the basis of conventional treatment and care.One hundred and six cases of mechanical ventilated patients without cluster intervening measures from June 2012 to December 2013 were selected as the control group.Retrospective survey was performed by reviewing the medical records of patients with invasive ventilation and filling in the table one by one.The mechanical ventilation time,hospital stays,morbidity and mortality of ventilator associated pneumonia（VAP）in two groups were observed and compared.Result：The mechanical ventilation time and hospitalization time of patients in intervention group was significantly less than the control group[（11.4±2.2）d vs.（16.3±3.1）d,（12.5±4.4）d vs.（17.8±5.2）d,P〈0.05].After intervention,patients in intervention group had the morbidity of VAP being 14.6%（13/89）,the mortality of VAP being 30.8 %（4/13）.Patients in the control group had the morbidity of VAP being 36.8%（39/106）,the mortality of VAP being 43.6%（17/39）.The VAP morbidity of intervention group was significantly lower than that of control group（P〈0.01）,but the VAP mortality of two groups had no statistical difference.Conclusion：The effect of cluster intervention on prevention of VAP is significant.

关 键 词：呼吸机相关肺炎 集束化干预措施 

分 类 号：R563.1[医药卫生—呼吸系统]