ICU 气管切开患者肺部感染危险因素分析及护理对策  

Analysis of the risk factors for ICU patients with lung infection after tracheotomy and its nursing countermeasures

作　　者：邵春梅[1] 王淑敏[2] 

机构地区：[1]河南省商丘市第一人民医院外科, 476100 [2]河南省商丘市第一人民医院ICU, 476100

出　　处：《中华现代护理杂志》2016年第15期2097-2100,共4页Chinese Journal of Modern Nursing

摘　　要：目的：针对 ICU 气管切开患者肺部感染现状、原因及其护理对策进行研究。方法随机选择2013年12月—2015年9月河南省商丘市第一人民医院 ICU 气管切开患者200例为本次研究对象，针对其肺部感染发生率、肺部感染发生的原因、肺部感染的致病菌、肺部感染发生的时间等指标进行观察分析，根据患者肺部感染发生的因素，实施有效的护理对策。结果本次研究中 ICU 气管切开患者肺部感染发生率为37．50％，患者肺部感染发生在 ICU 患者气管切开的时间受多种因素的影响，肺部感染发生的时间不同。造成肺部感染的致病菌主要有肺炎链球菌、铜绿假单胞菌、溶血性链球菌、耐甲氧西林黄色葡萄球菌、鲍曼不动杆菌，且致病菌所占的比例分别为44．00％，24．00％，16．00％，10．67％，5．33％。造成肺部感染的因素有：气管切开致病菌侵入、误吸及气道分泌物积聚、药物因素、交叉感染、免疫力差。结论ICU 气管切开患者病情严重，因为气管切开、免疫力差、应用药物等因素的影响，肺部感染发生率较高，且致病菌较多，对其实施有效的护理干预，可以降低肺部感染发生率。Objective To research the lung infection status,causes and nursing countermeasures on ICU patients with tracheotomy.Methods A study sample of 200 ICU patients with tracheotomy from the First People′s Hospital of Shangqiu were randomly collected from December of 201 3 to September 201 5.Observation and analysis against the lung infection incidence,causes,pathogens,occurrence time etc.were conducted,and effective nursing strategies were implemented based on the analysis of those occurrence factors for the patients with pulmonary infection.Results The incidence of pulmonary infection was 37.50% for ICU patients after tracheotomy in this study,the occurrence time of pulmonary infection in ICU patients varied due to multiple factors;the main pathogenic bacteria of pulmonary infection were streptococcus pneumoniae,pseudomonas aeruginosa,hemolytic streptococcus,methicillin-resistant staphylococcus aureus and acinetobacter baumannii, with proportions of 44.00%,24.00%,1 6.00%,1 0.67%,5.33% to the overall pathogens respectively.The factors in causing lung infection were：pathogen invasion caused by tracheotomy,aspiration and airway secretions accumulating,drug factors,cross infection and poor immunity.Conclusions ICU patients with tracheotomy are seriously ill,and the incidence of pulmonary infection is relatively high because of tracheotomy,poor immunity and drug application in addition to a plenty of pathogen.An effective nursing intervention can reduce the incidence of pulmonary infection.

关 键 词：护理 气管切开术 肺疾病 重症监护患者 危险因素 

分 类 号：R473.6[医药卫生—护理学]