督导式预警性护理模式结合复方氯己定含漱液声门下冲洗引流在重症脑卒中机械通气护理中的应用效果  

Application effect of supervised early warning nursing model combined with compound gargle solution chlorhexidine giuconaie subglottic irrigation and drainage in mechanical ventilation nursing of severe stroke

作　　者：栾成艳 郭明 LUAN Chengyan;GUO Ming(Ankang Central Hospital,Ankang 725000,China)

机构地区：[1]安康市中心医院,陕西安康725000

出　　处：《临床医学研究与实践》2024年第21期164-167,共4页Clinical Research and Practice

摘　　要：目的探究督导式预警性护理模式结合复方氯己定含漱液声门下冲洗引流在重症脑卒中机械通气护理中的应用效果。方法选择2019年1月至2021年12月我院接收的102例重症脑卒中机械通气患者作为研究对象,以随机数字表法将其分为对照组和观察组,各51例。对照组接受常规护理,观察组在对照组基础上加施督导式预警性护理模式结合复方氯己定含漱液声门下冲洗引流。比较两组的干预效果。结果观察组的呼吸机相关性肺炎发生率、痰痂形成率、口咽与气管内定植菌发生率、口腔炎症发生率显著低于对照组(P<0.05)。出ICU时,观察组的气道阻力(Raw)、气道峰压(PIP)低于对照组(P<0.05)。出ICU时,观察组的过氧化物还原蛋白1(PRDX1)、可溶性髓样细胞触发受体-1(sTREM-1)水平低于对照组(P<0.05)。结论督导式预警性护理模式结合复方氯己定含漱液声门下冲洗引流可调节PRDX1、sTREM-1水平,降低呼吸机相关性肺炎及并发症发生率,改善患者呼吸力学参数。Objective To explore the application effect of supervised early warning nursing model combined with compound gargle solution chlorhexidine giuconaie subglottic irrigation and drainage in mechanical ventilation nursing of severe stroke.Methods A total of 102 patients with severe stroke receiving mechanical ventilation in our hospital from January 2019 to December 2021 were selected as the research objects,and the patients were divided into control group and observation group by random number table method,with 51 cases in each group.The control group received routine nursing,while the observation group received supervised early warning nursing model combined with compound gargle solution chlorhexidine giuconaie subglottic irrigation and drainage on the basis of the control group.The intervention effects of the two groups were compared.Results The incidence of ventilator-associated pneumonia,sputum scab formation rate,oropharyngeal and tracheal colonization bacteria,and oral inflammation in the observation group were significantly lower than those in the control group(P<0.05).At ICU discharge,the airway resistance(Raw)and peak inflation pressure(PIP)in the observation group were lower than those in the control group(P<0.05).At ICU discharge,the levels of peroxiredoxin 1(PRDX1)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in the observation group were lower than those in the control group(P<0.05).Conclusion The supervised early warning nursing model combined with compound gargle solution chlorhexidine giuconaie subglottic irrigation and drainage can regulate the levels of PRDX1 and sTREM-1,reduce the incidence of ventilator-associated pneumonia and complications,and improve the respiratory mechanics parameters of patients.

关 键 词：督导式预警性护理模式 复方氯己定含漱液 声门下冲洗引流 重症脑卒中 机械通气 

分 类 号：R473[医药卫生—护理学]