基于风险识别的目标强化干预在ICU重症心力衰竭机械通气护理中的应用观察  

Observation on the Application of Target Intensive Intervention Based on Risk Identification inMechanical Ventilation Nursing of Severe Heart Failure in ICU

作　　者：陈樱 郑青青 吴莉玲 CHEN Ying;ZHENG Qingqing;WU Liling(Department of Intensive Care Unit,Fujian University of Traditional Chinese Medicine Affiliated People's Hospital,Fuzhou 350004,China)

机构地区：[1]福建中医药大学附属人民医院重症医学科,福州350004

出　　处：《中国医药指南》2024年第31期170-173,共4页Guide of China Medicine

摘　　要：目的探讨分析基于风险识别的目标强化干预在重症监护室(ICU)重症心力衰竭机械通气护理中的应用观察。方法选取2020年2月至2023年2月我院ICU收治的重症心力衰竭行机械通气患者60例,根据入院时间将纳入对象分为对照组(给予常规护理干预),观察组(在对照组基础上给予基于风险识别的目标强化干预),每组患者各30例,两组均持续干预2周,比较两组患者干预前后心功能指标、血气指标、急性生理和慢性健康状况评估Ⅱ(APACHEⅡ)、住院所需时间、机械通气时间、并发症发生率。结果干预2周后,观察组心功能水平均优于对照组(均P<0.05);干预2周后,观察组动脉血氧分压(PaO_(2))、血氧饱和度(SpO_(2))水平分别为(86.97±8.12)mmHg、(93.32±3.22)%高于对照组,二氧化碳分压(PaCO_(2))、APACHEⅡ评分分别为(48.67±6.46)mmHg、(17.66±5.77)分低于对照组(均P<0.05);观察组总住院时间(12.17±3.05)d、ICU住院时间(8.69±2.14)d、机械通气时间(4.92±1.28)d均短于对照组(均P<0.05);观察组和对照组的并发症(肺部感染、鼻面部压伤)总发生率分别为10.00%、20.00%,比较差异无统计学意义(P>0.05)。结论基于风险识别的目标强化干预能明显改善ICU重症心力衰竭患者心功能和血气指标,缩短患者住院时间和机械通气时间。Objective To investigate and analyze the application of target intensive intervention based on risk identification in intensive care unit(ICU)mechanical ventilation nursing of severe heart failure.Methods Sixty patients with severe heart failure undergoing mechanical ventilation admitted to the ICU of our hospital from February 2020 to February 2023 were selected,and according to the time of admission,the included subjects were divided into the control group(given routine nursing interventions),and the observation group(given risk-identification-based goalenhancing interventions based on the control group),with 30 patients in each group,and the interventions were continued for 2 weeks in both groups.Comparison of cardiac function indices,blood gas indices,Acute Physiological and Chronic Health EvaluationⅡ(APACHEⅡ),time required for hospitalisation,duration of mechanical ventilation,and complication rate before and after intervention in both groups.Results After 2 weeks of intervention,the cardiac function of the observation group was better than that of the control group(all P<0.05).After 2 weeks of intervention,the levels of partial pressure of oxygen(PaO_(2))and oxygen saturation of blood(SpO_(2))in the observation group were(86.97±8.12)mmHg and(93.32±3.22)%,which higher than control group,and the scores of partial pressure of carbon dioxide(PaCO_(2))and APACHEⅡwere(48.67±6.46)mmHg and(17.66±5.77),lower than those of the control group(all P<0.05).The total hospital stay(12.17±3.05)d,ICU stay(8.69±2.14)d and mechanical ventilation time(4.92±1.28)d of the Lower than control group(all P<0.05).The total complication(Lung infection,nose and face trauma)rates of the observation and control groups were 10.00%and 20.00%,the difference between the two was not significant(P>0.05).Conclusions Targeted intensive intervention based on risk identification can significantly improve cardiac function and blood gas indexes in ICU patients with severe heart failure,shorten hospital stay and mechanical ventilation tim

关 键 词：风险识别 目标强化干预 重症监护室 重症心力衰竭 机械通气 

分 类 号：R541.6[医药卫生—心血管疾病] R473.5[医药卫生—内科学]