集束化护理模式对ICU病房中使用呼吸机支持患者相关性肺炎发生的影响  

Cluster nursing model for patients with ICU in the use of ventilator support patients with pneumonia occurred

作　　者：熊杰[1] 涂莉娜[1] 郭春玲[1] 邹灯秀[1] 凃敏[2] 

机构地区：[1]华中科技大学同济医学院附属同济医院ICU,武汉430030 [2]华中科技大学同济医学院附属同济医院医院感染管理科

出　　处：《临床急诊杂志》2016年第10期786-788,791,共4页Journal of Clinical Emergency

摘　　要：目的:探讨集束化护理模式对ICU病房中使用呼吸机支持的患者发生相关性肺炎的影响。方法:选取2014-07-2015-01我院急诊ICU病房治疗的120例使用呼吸机进行机械通气的患者作为主要研究对象,采用随机数字表法将患者分为护理组(60例)及对照组(60例);护理组采用集束化护理模式,对照组采用常规护理模式;对患者进行为期6个月追踪护理,对比2组患者的机械通气时间、ICU住院时间、呼吸机相关性肺炎发生率、护理前后血气分析指标变化情况。结果:护理组患者机械通气时间、ICU住院时间均显著低于对照组(P<0.05);护理组患者的呼吸机相关性肺炎发生率及意外脱管者较对照组明显减少(P<0.05);2组患者干预前3个指标比较差异均无统计学意义;2组患者护理前后指标均明显改善(P<0.01),护理组与对照组比较,患者干预后PO2值明显升高,干预后PCO_2值明显降低(P<0.01);2组患者在干预后HR比较差异无统计学意义。结论:采用集束化护理模式能够减少患者机械通气用时、降低住院时间、改善患者血气分析指标,有效避免患者呼吸机相关性肺炎及意外脱管的发生,值得临床推广应用。Objective：To explore the effect of cluster nursing care model on the incidence of pneumonia in patients with ICU.Method：One hundred and twenty patients with mechanical ventilation in our hospital from July2014 to January 2015 were selected as the main research subjects in patients who were treated with mechanical ventilation,The patients were divided into nursing group（60cases）and control group（60cases）by random digital table method.The nursing group was adopted cluster nursing mode and the control group was adopted the routine nursing mode,The patients were followed up for 6 months.The changes of the mechanical ventilation time,ICU length of stay,incidence of ventilator associated pneumonia and blood gas analysis before and after nursing were compared between the two groups.Result：The time of mechanical ventilation and ICU stay in the nursing group were significantly lower than those in the control group（P〈0.05）;Compared with the control group,the incidence of ventilator associated pneumonia（P〈0.05）in the nursing group was significantly decreased compared with the control group.Before the intervention of the two groups were three indicators showed no significant difference;indicators before and after nursing,the patients in the two groups were significantly improved（P〈0.01）nursing group and control group,patients after intervention of PO2 values increased significantly,intervention PCO2 values decreased significantly（P〈0.01）.There was no statistical significance in the two groups of patients with HR.Conclusion：The cluster based nursing can reduce the patients with mechanical ventilation,reduce hospitalization time,improve the blood gas analysis index,effectively avoid patients with ventilator-associated pneumonia and accidental removal pipe,it is worth of clinical application.

关 键 词：集束化护理模式 重症监护病房 呼吸机 相关性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]