PICU肺炎患儿清理呼吸道无效现状及预测因子研究  

Prevalence and predictors of ineffective airway clearance among children with pneumonia in PICU

作　　者：王怡萱 汪晖 乐霄 李苏雅 蒋梦瑶 Wang Yixuan;Wang Hui;Yue Xiao;Li Suya;Jiang Mengyao(Department of Nursing,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院护理部,湖北武汉430030 [2]华中科技大学同济医学院护理学院 [3]华中科技大学同济医学院附属同济医院综合医疗科

出　　处：《护理学杂志》2023年第3期1-4,共4页Journal of Nursing Science

基　　金：华中科技大学同济医学院附属同济医院科研基金资助项目(2018C09)。

摘　　要：目的探索PICU肺炎患儿清理呼吸道无效现状和预测因子,为护理人员预防和识别肺炎患儿清理呼吸道无效提供参考。方法采取整群抽样方法,选择武汉市3所三级甲等医院PICU住院肺炎患儿302例为研究对象,对患儿一般资料、临床疾病资料、清理呼吸道无效相关临床指征和发生情况进行评估和调查。结果227例(75.17%)患儿发生清理呼吸道无效,logistic回归分析结果显示,患儿无效咳嗽、有痰鸣音和痰液黏稠是清理呼吸道无效的预测因子(均P<0.05)。结论PICU肺炎患儿清理呼吸道无效发生率较高,无效咳嗽、有痰鸣音和痰液黏稠的患儿更易发生清理呼吸道无效。临床医护人员需加强对患儿咳嗽能力、呼吸音和痰液的评估,以便早期识别肺炎患儿清理呼吸道无效,并采取相应措施以保证呼吸道通畅。Objective To explore the prevalence and predictors of ineffective airway clearance(IAC) in children with pneumonia in PICU, and to provide reference for nurses to prevent and identify IAC.Methods Cluster sampling method was used and a total of 302 pneumonia children admitted to PICU in 3 3A hospitals were selected.General information, clinical disease information, clinical indications and occurrence of IAC were collected.Results Totally, 227 children(75.17%) developed IAC.Binary logistic regression analysis showed that ineffective cough, phlegm sound and viscous sputum were predictors of IAC(P<0.05 for all).Conclusion The incidence of IAC is high in children with pneumonia in PICU, and the children with ineffective cough, phlegm sound and viscous sputum are more prone to develop IAC.Clinical medical staff need to ramp up assessment of children′s ability tocough, of breathing sounds and sputum, so as to identify IAC early on and take appropriate measures.

关 键 词：儿童 肺炎 儿童重症监护病房 清理呼吸道无效 咳嗽 痰鸣音 痰液黏稠 预测因子 

分 类 号：R473.72[医药卫生—护理学]