呼吸机相关性肺炎综合干预策略的临床效果分析  

Clinical effect of comprehensive intervention strategy on ventilator-associated pneumonia

作　　者：卢阳珍 金艳艳 何雪芬 

机构地区：[1]东阳市人民医院急诊重症监护室,浙江东阳322100

出　　处：《中华医院感染学杂志》2016年第22期5128-5130,共3页Chinese Journal of Nosocomiology

摘　　要：目的探索呼吸机相关性肺炎(VAP)非抗菌药物综合干预策略在临床应用的效果。方法选择2014年1月-2015年12月入住重症监护病房气管插管有创呼吸机辅助通气的患者开展统计;其中将2014年1月-12月患者按呼吸机的护理常规进行护理作为对照组,共3 858人;将2015年1月-12月的患者,共4 080人,实施依从性监测作为实验组;通过开展呼吸机相关性肺炎预防与控制措施的依从性监测(洗手、口腔卫生、半卧位等依从性),同时监测呼吸机相关性肺炎的发生率。结果用氯已定每天三次口腔护理完成率达100%、半卧位依从性达98.82%、洗手的依从性达到85%以上;2014年收住患者中呼吸机相关性肺炎发生率25.7‰,2015年收治患者中呼吸机相关性肺炎的发生率13.97‰。结论呼吸机相关性肺炎非抗菌药物综合干预策略可提高洗手、口腔卫生、半卧位等依从性,从而显著降低呼吸机相关肺炎的发生率。OBJECTIVE To explore the clinical effect of non‐antibiotic comprehensive intervention strategy on venti‐lator‐associated pneumonia （VAP） .METHODS The patients who received invasive ventilator‐assisted ventilation through endotracheal intubation in the intensive care unit （ICU） from Jan 2014 to Dec 2015 were enrolled in the study ;totally 3 858 patients who were given the nursing according to the conventional nursing from Jan 2014 to Dec 2014 were assigned as the control group ,and 4 080 patients who were treated with surveillance of compliance from Jan 2015 to Dec 2015 were set as the experimental group .The surveillance of compliance of the prevention and control measures （ hand washing ,oral hygiene ,semireclining position） was conducted ,and the incidence of VAP was monitored .RESULTS The rate of completing the oral care with chlorhexidine three times a day was 100% ,the compliance of semireclining position reached 98 .82% .The incidence of VAP was 25 .7‰ in the pa‐tients who were hospitalized in 2014 ,13 .97‰ in the patients who were treated in 2015 .CONCLUSION The non‐antibiotic comprehensive intervention strategy for the VAP can improve the compliance of hand washing ,oral hy‐giene ,and semireclining position so as to remarkably reduce the incidence of VAP .

关 键 词：非抗菌药物综合干预策略 呼吸机相关性肺炎 预后 

分 类 号：R563.1[医药卫生—呼吸系统]