体外膜肺氧合患者集束化护理干预的效果评价  

Evaluation of the effectiveness of cluster nursing intervention for extracorporeal membrane oxygenation patients

作　　者：叶婷 鲁玉凤[1] 袁萍 王凤珍[1] YE Ting;LU Yufeng;YUAN Ping;WANG Fengzhen(First Affiliated Hospital of Gannan Medical University,Ganzhou,341000,China)

机构地区：[1]赣南医学院第一附属医院重症医学科二区,江西省赣州市341000

出　　处：《护理实践与研究》2023年第20期3141-3146,共6页Nursing Practice and Research

基　　金：赣州市指导性科技计划任务(编号:GZ2018ZSF095)。

摘　　要：目的探讨集束化护理干预应用于体外膜肺氧合(ECMO)患者中的效果,为减少及预防ECMO并发症提供新思路。方法选取2019年1月—2020年12月在赣南医学院第一附属医院接受ECMO治疗的患者98例,按照组间基线资料均衡可比的原则分为对照组和观察组,各49例,对照组给予常规护理干预,观察组给予集束化护理干预,比较两组ECMO并发症发生情况、血气指标、ECMO术后监测指标。结果观察组ECMO并发症发生率低于对照组,差异具有统计学意义(P<0.05)。干预第1天两组患者动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、氧合指数(OI)比较,差异均无统计学意义(P>0.05);干预第7天观察组患者PaCO_(2)低于对照组,PaO_(2)、OI高于对照组,差异具有统计学意义(P<0.05)。观察组患者机械通气时间、入住ICU时间、ECMO辅助时间短于对照组,差异具有统计学意义(P<0.05)。观察组患者撤机成功率高于对照组,差异具有统计学意义(P<0.05)。结论集束化护理干预应用于ECMO患者中,可有效降低ECMO并发症发生率,改善患者的血气指标,保障ECMO的治疗成功和正常运转。Objective To explore the effect of cluster nursing intervention in extracorporeal membrane oxygenation(ECMO)patients and provide new ideas for reducing and preventing ECMO complications.Methods A total of 98 patients who received ECMO treatment at the First Affiliated Hospital of Gannan Medical University from January 2019 to December 2020 were selected and divided into a control group and an observation group of 49 cases each according to the principle of balanced and comparable baseline data between groups.The control group was given routine nursing intervention,and the observation group was given cluster nursing intervention.The occurrence of ECMO complications,blood gas indicators,and post-ECMO monitoring indicators were compared between the two groups.Results The incidence of ECMO complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).On the 1st day of intervention,there was no statistically significant difference in the partial pressure of carbon dioxide in artery(PaCO_(2)),partial pressure of oxygen(PaO_(2)),and oxygenation index(OI)between the two groups(P>0.05).On the 7th day of intervention,the PaCO_(2) of the observation group was lower than that of the control group,the PaO_(2) and OI of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The mechanical ventilation time,ICU admission time,and ECMO assistance time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The weaning success rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The application of cluster nursing intervention in ECMO patients can effectively reduce the incidence of ECMO complications,improve patients'blood gas indicators,and ensure the successful treatment and normal operation of ECMO.

关 键 词：集束化护理 体外膜肺氧合 机械通气 并发症 血气指标 

分 类 号：R473.6[医药卫生—护理学]