重症颅脑损伤患者应用针对性气道护理干预对排痰效果及VAP发生率的影响  

Effect of targeted airway nursing intervention on the sputum excretion and incidence of VAP in patients with severe craniocerebral injury

作　　者：赵调调 白雷丽[1] ZHAO Tiao-tiao;BAI Lei-li(Yan＇an People＇s Hospital,Yan＇an 716000,China)

机构地区：[1]陕西省延安市人民医院,陕西延安716000

出　　处：《临床医学研究与实践》2018年第18期165-166,共2页Clinical Research and Practice

摘　　要：目的探讨重症颅脑损伤患者应用针对性气道护理干预对排痰效果、VAP发生率的影响。方法随机将我院护理部2014年3月至2017年3月收治的600例重症颅脑损伤患者,分为试验组和参照组,每组300例。试验组、参照组分别实施针对性气道护理干预、常规护理干预,比较两组患者血气指标、排痰情况、呼吸机相关性肺炎VAP情况。结果护理后,两组PaO_2、SaO_2均显著升高,且试验组高于参照组(P<0.05)。试验组每日排痰量、吸痰次数和时间均显著优于参照组(P<0.05)。试验组中无VAP病例,死亡率为4.00%,参照组VAP发生率为4.67%,死亡率为11.67%,差异均存在统计学的意义(P<0.05)。结论针对性气道护理干预应用于重症颅脑损伤患者中,可改善患者的排痰情况,降低VAP发生率和死亡率。Objective To explore the effect of targeted airway nursing intervention on the sputum excretion andincidence of VAP in patients with severe craniocerebral injury. Methods Six hundred cases of severe craniocerebral injurycollected in nursing department of our hospital from March 2014 to March 2017 were selected and randomly divided intoexperimental group and reference group, with 300 cases in each group. The experimental group was given targeted airwaynursing intervention, and the reference group was given routine nursing intervention. The blood gas index, sputum excretionand ventilator associated pneumonia VAP were compared between the two groups. Results After nursing, the oxygenpressure （PaO2） and arterial oxygen saturation （SaO2） of the two groups significantly incresased, and those of the experimentalgroup were higher than the reference group （P〈0.05）. The daily expectoration, the number of sputum absorption and sputumabsorption time of the experimental group were higher than those of the reference group （P〈0.05）. The incidence of VAP andmortality in the experimental group were 0.00%, 4.00% respectively, and the incidence of VAP and mortality in thereference group were 4.67% and 11.67% respectively, and the differences were statistically significant between the twogroups（P〈0.05）. Conclusion The application of targeted airway nursing intervention in patients with severe craniocerebralinjury can improve the sputum excretion of the patients and reduce the incidence of VAP and mortality.

关 键 词：重症颅脑损伤 针对性气道护理干预 排痰 VAP发生率 

分 类 号：R473[医药卫生—护理学]