呼吸机集束化综合管理措施对机械通气新生儿并发呼吸机相关性肺炎的影响  

Effect of integrated management of ventilator bundle on VAP in children with mechanical ventilation

作　　者：李淑娟[1] 刘树艳[1] 赵俊荣[1] 闫岩[1] 刘丽丽[1] LI Shujuan;LIU Shuyan;ZHAO Junrong;YAN Yan;LIU Lili(Department of Infection Management,Tangshan Maternal and Child Health Hospital, Tangshan,Hebei 063000,China)

机构地区：[1]唐山市妇幼保健院感染管理科,河北唐山063000

出　　处：《安徽医药》2018年第12期2404-2406,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨呼吸机集束化(VB)综合管理措施对预防控制新生儿重症监护病房(NICU)中机械通气患儿并发呼吸机相关性肺炎(VAP)的影响。方法回顾性分析唐山市妇幼保健院NICU 2014年12月至2017年1月收治的机械通气患儿118例,根据护理管理措施的不同分为对照组(58例)和观察组(60例)。对照组给予常规护理,未给予VB综合管理措施,观察组根据VAP发生的危险因素实施呼吸机集束化综合管理措施,来预防新生儿VAP。对比两组的呼吸机相关性肺炎的发病率、相关观察指标。结果观察组早发性VAP发生率(3. 33%)、迟发性VAP发生率(11. 67%)、住院时间(14. 20±2. 30) d、病死率(8. 33%)均低于对照组(P <0. 05),其脱呼吸机成功率(73. 33%)和对照组比较明显升高,差异有统计学意义(P <0. 05)。结论对于NICU中机械通气患儿来说,应用呼吸机集束化综合管理措施可有效预防呼吸机相关性肺炎的发生,提高脱呼吸机成功率,降低病死率。Objective To study the risk factors of ventilator-associated pneumonia(VAP)in the neonatal intensive care unit(NICU),establish ventilator bundle(VB)comprehensive management measures for prevention and control of neonatal VAP,reduce neonatal morbidity and mortality VAP.Methods 118 cases of patients with mechanical ventilation in NICU of Tangshan maternal and child health hospital from December 2014 to January 2017,divided into the control group(58 cases)and the observation group(60 cases)according to the different nursing measures,were retrospectively analyzed.The target monitoring,investigation and the control group NICU with the incidence of VAP,discuss its risk factors.The control group was just given routine nursing care,without VB comprehensive management measures.The observation group in accordance with the risk factors of VAP implementation of ventilator bundle integrated management measures to prevent neonatal VAP.The incidence of VAP in two groups was compared.Results The incidence of early-onset VAP(3.33%),delayed occurrence rate of VAP(11.67%),hospitalization time(14.20±2.30)d,the mortality rate(8.33%)of the observation group was lower than that of the control group(P<0.05),and the success rate of off ventilator(73.33%)was significantly increased than that of the control group(P<0.05).Conclusion For patients with mechanical ventilation in NICU,the application of cluster management can effectively prevent the occurrence of VAP,improve the success rate of respiratory failure,reduce the mortality rate.

关 键 词：集束化综合管理措施 呼吸机 机械通气 

分 类 号：R473.72[医药卫生—护理学]