基于改良肺部超声结果实施PDCA循环护理对ICU重症肺炎患者血生化指标和通气能力的影响  

Effect of PDCA circulating nursing based on improved lung ultrasound results on blood biochemical indexes and ventilation capacity of ICU patients with severe pneumonia

作　　者：林建华[1] 何林 LIN Jianhua;HE Lin(Department of Intensive Care Medicine,Ganzhou People's Hospital,Jiangxi Province,Ganzhou341000,China;Department of Emergency,Ganzhou People's Hospital,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]江西省赣州市人民医院重症医学科,江西赣州341000 [2]江西省赣州市人民医院急诊科,江西赣州341000

出　　处：《中国当代医药》2024年第5期179-182,187,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220219691)。

摘　　要：目的观察并探讨ICU重症肺炎患者临床护理过程中基于改良肺部超声结果进行PDCA循环护理干预的临床效果。方法选取2021年3月至2023年4月赣州市人民医院收治的60例重症肺炎患者作为研究对象,按照抛掷硬币法分为对照组(n=30)和观察组(n=30)。对照组辅以常规护理,观察组基于改良肺部超声结果辅以PDCA循环护理。比较两组患者用呼吸机辅助呼吸时间、入住ICU时间、血乳酸(LAC)、呼吸频率(RR)、氧合指数(P/F)、肺部超声评分、急性生理学与慢性健康状况系统(APACHEⅡ)评分、匹兹堡睡眠质量指数(PSQI)评分、不良反应、满意率。结果观察组用呼吸机辅助呼吸时间、入住ICU时间与短于对照组,差异有统计学意义(P<0.05)。两组护理后LAC、RR、肺部超声评分、APACHEⅡ评分、PSQI评分低于护理前,P/F高于护理前,且观察组护理后LAC、RR、肺部超声评分、APACHEⅡ评分、PSQI评分低于对照组,P/F高于对照组,差异有统计学意义(P<0.05)。观察组胸痛、低氧血症、寒战等不良反应总发生率低于对照组,差异有统计学意义(P<0.05);观察组患者对临床护理满意率高于对照组,差异有统计学意义(P<0.05)。结论基于改良肺部超声结果,对ICU重症肺炎患者进行PDCA循环护理,可以显著改善患者通气能力,减少不良反应,加速肺康复进程,提高预后质量,且备受患者认可,临床应用前景广阔。Objective To observe and discuss the clinical effect of PDCA cycle nursing intervention based on improved lung ultrasound results in ICU patients with severe pneumonia in the course of clinical nursing.Methods Sixty patients with severe pneumonia admitted to Ganzhou People's Hospital from March 2021 to April 2023 were selected as the study objects and divided into control group(n=30)and observation group(n=30)according to coin toss method.The control group received routine care,while the observation group received PDCA circulation care based on improved lung ultrasound results.The time of ventilator assisted breathing,stay in ICU,blood lactic acid(LAC),respiratory rate(RR),partial pressure of carbon dioxide/fraction of inspired oxygen(P/F),pulmonary ultrasound score,acute physiology and chronic health system(APACHEⅡ)score,and Pittsburgh sleep quality index(PSQI)score,adverse reactions,and satisfaction rate were compared between the two groups.Results The terms of assisted breathing time and ICU stay time of the observation group were shorter than those of the control group,the differences were statistically significant(P<0.05).After nursing,the LAC,RR,lung ultrasound score,APACHEⅡscore,and PSQI score of the two groups were lower than before nursing,and the P/F was higher than before nursing.In addition,the LAC,RR,lung ultrasound score,APACHEⅡscore,and PSQI score of the observation group were lower than the control group after nursing,and the P/F was higher than the control group,with statistical significances(P<0.05).The total incidence of chest pain,hypoxemia,chills and other adverse reactions in the observation group was lower than that in the control group,with a statistically significant difference(P<0.05).The satisfaction rate of clinical nursing in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05).Conclusion Based on improved lung ultrasound results,PDCA circulatory care for ICU patients with severe pneumonia can significantly improve t

关 键 词：重症肺炎 PDCA循环 超声 肺通气 

分 类 号：R473[医药卫生—护理学]