ICU专科护士实施早期肺康复方案在卒中相关性肺炎患者中的效果研究  

Effect of early pulmonary rehabilitation on stroke associated pneumonia by the ICU specialist nurses

作　　者：阮恒芳[1] 林蓉芳[1] 沈利平[1] 李莉莉[1] 张旭方 Ruan Hengfang;Lin Rongfang;Shen Liping;Li Lili;Zhang Xufang(ICU of Neurology Department,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院神经内科ICU,广州510630

出　　处：《中国实用护理杂志》2019年第9期654-658,共5页Chinese Journal of Practical Nursing

摘　　要：目的探讨ICU专科护士在卒中相关性肺炎患者中实施早期肺康复方案的效果。方法选取中山大学附属第三医院神经内科ICU2017年1-6月收治的40例急性脑卒中患者作为对照组,2017年7-12月收治的44例急性脑卒中患者作为干预组,对照组接受ICU脑卒中常规护理,干预组在此基础上由ICU专科护士进行早期肺康复方案干预,比较2组患者卒中相关性肺炎(SAP)的发生率、ICU住院时间和机械通气时间等结局指标。结果干预组的SAP发生率为13.64%(6/44),低于对照组的32.50%(13/40),差异有统计学意义(χ^2=4.26,P<0.05);干预组的ICU住院时间和机械通气时间分别为(5.59±3.93)、(3.2±0.84)d,均低于对照组(8.50±7.89)、(13.13±9.58)d,差异有统计学意义(t=2.106、2.678,P<0.05);干预组的血清前白蛋白为(219.43±59.71)mg/L,高于对照组的(192.20±54.85)mg/L,差异有统计学意义(t=-2.170,P<0.05)。结论ICU专科护士实施早期肺康复方案对降低卒中后相关肺炎及改善临床结局上有较好的效果,方案值得推广,同时需进一步完善SAP的风险评估及吞咽与营养的管理。Objective To explore the effect of early pulmonary rehabilitation on stroke associated pneumonia by the ICU specialist nurses.MethodsTotally 40 cases of stroke patients from January 2017 to June 2017 were selected into the control group,and 44 cases of stroke patients from July 2017 to December 2017 were set as the intervention group.The patients in the control group were given routine care,and those in the experimental group were given early pulmonary rehabilitation in addition to routine care by ICU specialist nurses.The clinical outcome such as the occurrence of SAP,the length of intensive care units(ICU)stay and the duration of mechanical ventilation were compared.ResultsThe incidence of SAP in the intervention group was 13.64%(6/44),significantly lower than that 32.50(13/40)in the control group(χ^2=4.26,P<0.05),and the length of ICU stay the duration of mechanical ventilation were(5.59±3.93),(3.2±0.84)days,which were lower than(8.50±7.89),((13.13±9.58)days in the control group(t=2.106,2.678,P<0.05),the prealbumin levels was(219.43±59.71)mg/L,higher than(192.20±54.85)mg/L in the control group(t=-2.170,P<0.05),the difference was statistically significant.ConclusionEarly pulmonary rehabilitation can effectively reduce the incidence of SAP and better clinical outcome.And we also should improve the SAP risk assessment and the management of swallowing and nutrition.

关 键 词：肺康复 卒中相关性肺炎 专科护士 重症监护病房 

分 类 号：R473.74[医药卫生—护理学]