体位护理对机械通气相关性肺炎影响的研究

Study of the effect of postural care on ventilator-associated pneumonia

目的 探讨体位护理对机械通气相关肺炎（VAP）发病率和临床预后的影响。方法对2003年1月～2005年12月急诊和ICU的病人29例进行研究，设实验组和对照组比较，进行前瞻性观察，对病人VAP发生率、在ICU的天数、住院天数和住院费用进行统计分析。结果实验组VAP发生率为5／17，对照组VAP发生率为9／12，2组间比较有显著性差异（P〈0．05）；VAP阴性组平均住院天数为（15．1±1．9）d，VAP阳性组为（18．8±2．8）d，2组间有显著性差异（P〈0．05）；但VAP阳性病人体位护理与无体位护理2组在ICU的天数无明显差异。结论体位护理可以减少VAP的发病率，缩短住院天数，减少医药费用，是一种值得临床推广的护理新技术。

Objective To explore the effect of postural care on the incidence and clinical prognosis of ventilator-associated pneumonia （VAP） in the patients receiving mechanical ventilation. Methods A prospective study was made on 29 patients in the emergency department and ICU between January of 2004 and December of 2005. All cases were randomly divided into the postural care group and the control group for comparison. The incidence rate of VAP, the hospital days, the days in ICU and the cost of hospitalization were statistically analyzed. Results The incidence rate of VAP in the postural nursing group was 5/17, and the incidence rate of VAP in the control group was 9/12. There was a significant difference between the two groups （ P 〈0. 05）. The average hospital days of patients with negative VAP were 15.1±1.9, and the average hospital days of patients with positive VAP were 18.8±2.8, showing a significant difference between the two groups （ P 〈0.05）. In ICU time of the patients with positive VAP had no significant difference between the two groups when having postural care and having no postural care （P〉 0.05）. Conclusions Postural nursing is a new technology of nursing care and worthy of extending. Postural nursing can decrease the incidence rate of VAP, shorten the hospital days and reduce the cost of hospitalization in patients receiving ventilation.