影响分析理论对老年机械通气患者呼吸机相关性肺炎的预防价值  

Value of failure model effectiveness analysis in preventing ventilator associated pneumonia in elderly patients with mechanical ventilation

作　　者：龙苗[1] 贾叙锋[2] 邓海波[1] 黄象丽 何平[3] LONG Miao;JIA Xufeng;DENG Haibo;HUANG Xiangli;HE Ping(Department of Respiratory Medicine,the People′s Hospital of Jianyang City in Sichuan Province,Jianyang641400,China;Department of Orthopedics,the People′s Hospital of Jianyang City in Sichuan Province,Jianyang641400,China;Department of Nursing,the People′s Hospital of Jianyang City in Sichuan Province,Jianyang641400,China)

机构地区：[1]四川省简阳市人民医院呼吸科,四川简阳641400 [2]四川省简阳市人民医院骨科,四川简阳641400 [3]四川省简阳市人民医院护理部,四川简阳641400

出　　处：《中国现代医生》2021年第11期163-166,共4页China Modern Doctor

基　　金：四川省护理科研课题(H18045)。

摘　　要：目的探讨影响分析理论(FMEA)的护理干预在老年机械通气患者呼吸机相关性肺炎(VAP)预防中的价值。方法选取本院2017年2月至2019年3月收治的92例机械通气患者作为研究对象采用随机数表法分为观察组和对照组,每组各46例。对照组行常规护理干预预防VAP,观察组在FMEA指导下行护理干预预防VAP。比较两组机械通气期间VAP发生率,两组干预前后氧化应激反应及呼吸力学指标变化[丙二醛(MDA)、超氧化物歧化酶(SOD)、气道峰压(PIP)、气道阻力(AR)],并比较两组机械通气时间及住院时间。结果观察组干预后VAP发生率为4.35%,显著低于对照组的19.57%,差异有统计学意义(P<0.05)。观察组干预后MDA、PIP、AR水平显著低于干预前及对照组干预后,差异有统计学意义(P<0.05);观察组干预后SOD水平显著高于干预前及对照组干预后,差异有统计学意义(P<0.05)。观察组干预后机械通气时间及住院时间显著短于对照组,差异有统计学意义(P<0.05)。结论FMEA指导下行护理干预可降低VAP发生率,缩短老年患者机械通气时间及住院时间,具有较高的临床应用价值。Objective To explore the value of nursing intervention based on failure model effectiveness analysis(FMEA)in preventing ventilator associated pneumonia(VAP)in elderly patients with mechanical ventilation.Methods A total of 92 patients with mechanical ventilation admitted to our hospital from February 2017 to March 2019 were selected as the research objects,and they were divided into the observation group and the control group according to the random number table method each group had 46 cases.The control group was treated with conventional nursing intervention to prevent VAP,while the observation group was treated with nursing intervention to prevent VAP under the guidance of FMEA.The incidence of VAP during mechanical ventilation was compared between the two groups.Meanwhile,the changes of oxidative stress reaction and respiratory mechanics indexes,malondialdehyde(MDA),superoxide dismutase(SOD),peak inspiratory pressure(PIP),airway resistance(AR)before and after intervention were compared between the two groups.In addition,the time of mechanical ventilation and hospitalization in the hospi were compared between the two groups.Results The incidence of VAP in the observation group was 4.35%,significantly lower than 19.57%in the control group,with statistically significant difference(P<0.05).After the intervention,the levels of MDA,PIP and AR levels in the observation group were significantly lower than those in the control group before and after intervention,with statistically significant differences(P<0.05).The SOD level in the observation group after intervention was significantly higher than that before intervention and that in the control group after intervention,with statistically significant difference(P<0.05).After intervention,the time of mechanical ventilation and the hospitalization time in the observation group were significantly chorter than those in the control group,with statistically significant differences(P<0.05).Conclusion Nursing intervention guided by FMEA can reduce the incidence of VAP,shorte

关 键 词：影响分析理论 老年 机械通气 呼吸机相关性肺炎 

分 类 号：R181.3[医药卫生—流行病学]