精细化护理对预防神经外科重症气管切开患者呼吸机相关肺炎和改善通气的影响  

Effects of fine nursing on prevention of ventilator-associated pneumonia and ventilation improvement in severe neurosurgery patients with tracheotomy

作　　者：马苗苗[1] 袁媛 张云锋[2] MA Miaomiao;YUAN Yuan;ZHANG Yunfeng(Neurosurgery Department,Yan'an People's Hospital,Yan'an 716000;No.2 Thoracic Surgery Department,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]陕西省延安市人民医院神经外科,陕西延安716000 [2]西安交通大学第一附属医院胸外二科,陕西西安710061

出　　处：《临床医学研究与实践》2020年第35期169-171,共3页Clinical Research and Practice

基　　金：西安交通大学第一附属医院新医疗新技术项目(No.XJYFY-2017W57)。

摘　　要：目的观察精细化护理对神经外科重症气管切开患者呼吸机相关肺炎的预防作用和通气的改善效果。方法将于我院神经外科行重症气管切开的110例患者随机分为对照组和观察组,各55例。对照组给予常规护理,观察组给予精细化护理。比较两组的护理效果。结果气管切开7 d后,观察组的PaO2高于对照组,PaCO2、BE及APACHEⅡ评分低于对照组(P<0.05)。观察组机械通气时间和ICU住院时间短于对照组,呼吸机相关肺炎发生率和死亡率低于对照组(P<0.05)。观察组的护理质量及护理满意度高于对照组(P<0.05)。结论对神经外科重症气管切开的患者实施精细化护理,能有效改善患者的通气状况,降低呼吸机相关肺炎的发生率和死亡率,改善患者预后,提高护理质量和护理满意度。Objective To observe the effects of fine nursing on prevention of ventilator-associated pneumonia and ventilation improvement in severe neurosurgery patients with tracheotomy.Methods One hundred and ten severe patients with tracheotomy in neurosurgery department of our hospital were randomly divided into control group and observation group,with 55 cases in each group.The control group was given routine nursing,and the observation group was given fine nursing.The nursing effects of the two groups were compared.Results At 7 d after tracheotomy,PaO2 in the observation group was higher than that in the control group,while PaCO2,BE and APACHEⅡscore in the observation group were lower than those in the control group(P<0.05).The mechanical ventilation time and ICU hospitalization time in the observation group were shorter than those in the control group,and the incidence of ventilator-associated pneumonia and the mortality were lower than those in the control group(P<0.05).The nursing quality and nursing satisfaction in the observation group were higher than those in the control group(P<0.05).Conclusion Fine nursing applied in severe neurosurgery patients with tracheotomy can effectively ameliorate the ventilation status,reduce the incidence of ventilator-associated pneumonia and the mortality,and improve the prognosis,quality of nursing and nursing satisfaction of patients.

关 键 词：精细化护理 神经外科 气管切开 呼吸机相关肺炎 

分 类 号：R473.6[医药卫生—护理学]