心脏术后呼吸机相关性肺炎100例预防及护理

Prevention from ventilator-associated pneumonia after cardiac operation and nursing care of 100 patients

目的：探讨预防心脏术后呼吸机相关性肺炎的护理方法。方法：通过对200例心脏术后机械通气时间超过48h的患者进行分组护理，2004年1月～12月的100例为对照组，给予常规护理。2005年1月～12月的100例为系统护理组，除常规护理外，给予加强气道管理、基础护理和防止医源感染等系统化护理。结果：对照组发生呼吸机相关性肺炎12例，发病率为12％，死亡3例。系统护理组发生呼吸机相关性肺炎7例，发病率为7％，死亡1例。两组比较有显著性差异（P〈0．01）。结论：对心脏术后机械通气时间超过48h的患者给予合理有效的预防护理措施，能降低心脏术后呼吸机相关性肺炎的发生率及病死率。

Objective： To explore nursing methods in prevention from ventilator- associated pneumonia after cardiac operation. Methods： Two hundred patients who were treated with mechanical ventilator over 48 h after cardiac operation were divided into control group （ n = 100） and systematic nursing group （ n= 100）. Routine nursing care was given in control group and management of respiratory tract was additionally strengthened as well as essential nursing care, including sys- tematic nursing care to prevent from nosocomial infection in systematic nursing group. Results ： Ventilator - associated pneumonia occurred in 12 patients, the incidence was 12% and 3 patients died in control group; in systematic nursing group, ventilator- associated pneumonia occurred in 7 patients, the incidence was 7%, one patient died. There was significant difference in the comparison between the two groups （ P 〈 0. 01 ）. Conclusion： Proper and effective preventive nursing care can decrease the incidence and death rate of ventilator - associated pneumonia, especially for those patients who were treated with mechanical ventilator over 48 h after cardiac operation.