口鼻腔冲洗联合持续气囊压测定预防呼吸机相关性肺炎的研究  

Study on prevention of ventilator-associated pneumonia by oral and nasal irrigation combined with continuous balloon pressure measurement

作　　者：李淑燕[1] 李莉莉[1] 姚惠萍[2] 富燕萍[1] 李飞[1] 张帅 LI Shuyan;LI Lili;YAO Huiping;FU Yanping;LI Fei;ZHANG Shuai(Department of Intensive Care Unit,Zhejiang Provincial People's Hospital,People's Hospital of Hangzhou Medical College,Hangzhou 310014,China;?2 Department of Nursing,Zhejiang Provincial People's Hospital,People's Hospital of Hangzhou Medical College,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院,杭州医学院附属人民医院重症监护室,杭州310014 [2]浙江省人民医院,杭州医学院附属人民医院护理部,杭州310014

出　　处：《浙江医学教育》2022年第2期125-128,共4页Zhejiang Medical Education

基　　金：浙江省医药卫生科技面上项目:“口鼻腔冲洗联合持续气囊压测定在机械通气患者中的应用”(2020KY050)。

摘　　要：目的探讨口鼻腔冲洗联合持续气囊压测定在预防机械通气患者呼吸机相关性肺炎中的应用效果。方法采用便利抽样方法,选取浙江省人民医院重症监护室2019年7月至2020年8月收治的100例机械通气患者为研究对象。按照住院编号将尾号单数的患者设为试验组,尾号双数的患者设为对照组,每组50例患者。在预防呼吸机相关性肺炎常规护理基础上,试验组患者采用口鼻腔冲洗联合持续气囊压测定的护理,对照组患者采用口腔擦洗联合持续气囊压测定的护理。通过患者呼吸机相关性肺炎发生率、痰培养阳性病原菌检测结果、机械通气时间、ICU住院时间和住院费用等指标,比较两组患者的干预效果。结果干预后,试验组患者呼吸机相关性肺炎发生率(4.0%)、痰培养病原菌阳性率(6.0%)、机械通气时间[(9.7±1.3)天]、ICU住院时间[(12.1±1.4)天]和住院费用[(66910.8±2896.9)元]均低于对照组患者[18.0%、22.0%、(12.9±2.1)天、(14.9±1.4)天、(115254.4±8466.4)元],其差异均具有统计学意义(均P<0.05)。结论口鼻腔冲洗联合持续气囊压测定能够有效降低呼吸机相关性肺炎的发生率,缩短机械通气时间和ICU住院时间,有效降低住院费用,值得在临床推广应用。Objective To investigate the effect of oral and nasal irrigation combined with continuous balloon pressure measurement in the prevention of ventilator-associated pneumonia in patients with mechanical ventilation.Methods 100 patients with mechanical ventilation in the intensive care unit of Zhejiang Provincial People's Hospital from July 2019 to August 2020 were selected as the research object by convenience sampling method.According to the hospitalization number,the patients with odd tail number were divided into the experimental group,and the patients with even tail number were divided into the control group.On the basis of routine nursing for the prevention of ventilator-associated pneumonia,the experimental group was treated with oral and nasal flushing combined with continuous balloon pressure measurement,and the control group was treated with oral scrubbing combined with continuous balloon pressure measurement.The intervention effects of the two groups were compared by the incidence of ventilator-associated pneumonia,the detection results of sputum culture positive pathogens,mechanical ventilation time,ICU hospitalization time and hospitalization expenses.Results After intervention,the incidence of ventilator-associated(4.0%),sputum culture pathogen positive rate(6.0%),mechanical ventilation time[(9.7±1.3)days],ICU hospitalization time[(12.1±1.4)days]and hospitalization expenses[(66910.8±2896.9)yuan]in the experimental group were lower than those in the control group[18.0%,22.0%,(12.9±2.1)days,(14.9±1.4)days and(115254.4±8466.4)yuan,respectively].The difference was statistically significant(all P<0.05).Conclusions Oral and nasal irrigation combined with continuous balloon pressure measurement can effectively reduce the incidence of ventilator-associated pneumonia,shorten the duration of mechanical ventilation and ICU stay,and effectively reduce hospitalization costs,which is worthy of clinical application.

关 键 词：机械通气 呼吸机相关性肺炎 口鼻腔冲洗 持续气囊压 

分 类 号：R473.5[医药卫生—护理学]