基于循证理论的预见性护理策略结合声门下间歇冲洗预防2型糖尿病伴心力衰竭患者呼吸机相关性肺炎的效果及对炎性介质水平的影响  

Effect of predictive nursing strategy based on evidence-based theory combined with subglottic intermittent irrigation on the prevention of ventilator associated pneumonia in patients with type 2 diabetes mellitus and heart failure and its influence on the level of inflammatory mediator

作　　者：李花[1] 徐娟 朱海慧 LI Hua;XU Juan;ZHU Haihui(Critical Care Medicine Department,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000;Nephrology Department,Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University,Yulin 719000;Endocrinology Department,Shaanxi Provincial Hospital of Chinese Medicine,Xi'an 710003,China)

机构地区：[1]陕西中医药大学第二附属医院重症医学科,陕西咸阳712000 [2]西安交通大学第一附属医院榆林医院肾内科,陕西榆林719000 [3]陕西省中医医院内分泌科,陕西西安710003

出　　处：《临床医学研究与实践》2024年第18期126-129,共4页Clinical Research and Practice

基　　金：陕西省中医药管理局科研课题(No.2019-ZZ-LC003)。

摘　　要：目的分析基于循证理论的预见性护理策略结合声门下间歇冲洗在预防2型糖尿病(T2DM)伴心力衰竭(HF)患者呼吸机相关性肺炎(VAP)中的应用效果。方法择取2021年1月至2022年1月收治的100例T2DM伴HF患者为研究对象,随机将其分为对照组和观察组,各50例。对照组采用常规护理干预,观察组在对照组基础上加基于循证理论的预见性护理策略结合声门下间歇冲洗。比较两组的干预效果。结果观察组的VAP发生率、随机血糖水平低于对照组,机械通气时间、气管插管时间及住院时间短于对照组(P<0.05)。干预后,观察组的肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)及C反应蛋白(CRP)水平低于对照组(P<0.05)。干预后,观察组的脑钠肽(BNP)水平及糖化血红蛋白(HbA1c)低于对照组(P<0.05)。结论基于循证理论的预见性护理策略结合声门下间歇冲洗能够有效预防T2DM伴HF患者VAP的发生,降低炎性介质水平,改善血糖及心功能,值得临床推广与应用。Objective To analyze the application effect of predictive nursing strategy based on evidence-based theory combined with subglottic intermittent irrigation on the prevention of ventilator associated pneumonia(VAP)in patients with type 2 diabetes mellitus(T2DM)and heart failure(HF).Methods A total of 100 patients with T2DM and HF admitted from January 2021 to January 2022 were selected as the study objects and randomly divided into control group and observation group,with 50 cases in each group.The control group was given routine nursing intervention,and the observation group was given predictive nursing strategy based on evidence-based theory combined with subglottic intermittent irrigation on the basis of the control group.The intervention effects of the two groups were compared.Results The incidence of VAP and random blood glucose level in the observation group were lower than those in the control group,and the mechanical ventilation time,tracheal intubation time and hospitalization time were shorter than those in the control group(P<0.05).After intervention,the levels of tumor necrosis factor-α(TNF-α),procalcitonin(PCT)and C-reactive protein(CRP)in the observation group were lower than those in the control group(P<0.05).After intervention,the level of brain natriuretic peptide(BNP)and glycosylated hemoglobin(HbA1c)in the observation group were lower than those in the control group(P<0.05).Conclusion The predictive nursing strategy based on evidence-based theory combined with subglottic intermittent irrigation can effectively prevent the occurrence of VAP in patients with T2DM and HF,reduce the levels of inflammatory mediators,and improve blood glucose and cardiac function,which is worthy of clinical promotion and application.

关 键 词：循证理论 预见性护理策略 声门下间歇冲洗 2型糖尿病 心力衰竭 呼吸机相关性肺炎 炎性介质 心功能 

分 类 号：R473[医药卫生—护理学]