集束化护理管理对ICU脓毒症患者早期脱机的影响  

Effect of clustered nursing management on early offline of ICU patients with sepsis

作　　者：戴卫华[1] 谢波[1] 周庆[1] 邵丽芬 DAI Weihua;XIE Bo;ZHOU Qing;SHAO Lifen(ICU,Huzhou Central Hospital,Huzhou 313000,China)

机构地区：[1]浙江省湖州市中心医院重症医学科,浙江湖州313000

出　　处：《中国现代医生》2019年第1期132-135,共4页China Modern Doctor

基　　金：浙江省卫计委科技平台项目(2017ZD027)

摘　　要：目的探讨集束化护理管理对ICU脓毒症患者早期脱机的影响。方法选择我院2013年6月～2014年6月收入ICU治疗的脓毒症并且接受机械通气的患者100例,随机分为观察组(n=50)及对照组(n=50),对照组采用常规护理干预措施,在此基础上观察组增加集束化护理管理。记录每位患者脱机开始时的急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,血气分析,血钙、镁、磷,脱机前机械通气时间、脱机成功率、脱机成功所需次数、脱机全过程所需时间。结果脱机开始时,两组患者的APACHEⅡ评分、pH值、PaCO_2、血浆白蛋白水平、血清磷、镁、钙含量以及脱机前机械通气时间比较,差异均无统计学意义(P均>0.05)。观察组第7天和第14天时的脱机成功率显著高于对照组(76%vs 40%,86%vs 64%,χ~2=4.677,4.661,P=0.031,0.046)。此外,观察组脱机1次成功的患者明显高于对照组(40 vs 16,χ~2=5.350,P=0.034)。观察组脱机全过程所需时间明显低于对照组(8.54±2.09vs 13.32±2.19,t=9.320,P=0.045)。结论早期集束化护理干预可有效帮助ICU脓毒症患者的早期脱机,值得在临床上推广使用。Objective To investigate the effect of clustered nursing management on early offline of ICU patients with sepsis.Methods 100 patients with sepsis who were admitted to ICU for treatment in our hospital from June 2013 to June 2014 and were given mechanical ventilation were selected.They were randomly divided into observation group(n=50)and control group(n=50).The control group was given routine nursing interventions.On this basis,the observation group was further given the management of clustered care.The acute physiology and chronic health status scoring systemⅡ(APACHEⅡ)score,blood gas analysis,blood calcium,magnesium,phosphorus,mechanical ventilation time before offline,offline success rate,the number of times required for successful offline,and the time required for the whole process of offline were recorded in each patient at the beginning of offline.Results At the beginning of offline,there were no statistically significant differences in APACHEⅡscore,pH value,PaCO2,plasma albumin level,serum phosphorus,magnesium,calcium contents and mechanical ventilation time before offline between the two groups of patients(all P >0.05).The offline success rate on the 7th and 14th day in the observation group was significantly higher than that in the control group(76%vs 40%,86%vs 64%,χ^2=4.677,4.661,P=0.031,0.046).In addition,the number of patients with one-time successful offline in the observation group was significantly higher than that in the control group(40 vs 16,χ^2=5.350,P=0.034).The time required for the whole process of offline in the observation group was significantly lower than that in the control group(8.54±2.09 vs 13.32±2.19,t=9.320,P=0.045).Conclusion Early clustered nursing intervention can effectively help the early offline of ICU patients with sepsis,which is worthy of clinical promotion and application.

关 键 词：集束化护理 ICU 脓毒症 脱机 

分 类 号：R473.5[医药卫生—护理学]