呼吸机集束化干预策略对恶性肿瘤患者呼吸机相关性肺炎的预防效果

Effect of ventilator bundle for prevention of ventilator associated pneumonia in the patients with malignant tumor

目的 探讨呼吸机集束化干预策略在恶性肿瘤患者呼吸机相关性肺炎（VAP）的预防作用.方法 采用前瞻性研究方法,对我院147例ICU的机械通气恶性肿瘤患者进行集束化干预策略,采取抬高头部≥30°角体位、每日唤醒并评估患者进行脱机实验,预防消化性溃疡以及深静脉血栓的预防等措施.比较实施前后患者的机械通气时间、VAP发生率.结果 采用集束化干预策略后,患者VAP的发生率有所下降,机械通气时间缩短,入住ICU时间较对照组明显缩短.结论 呼吸机集束化干预策略可预防恶性肿瘤患者VAP的发生,值得临床推广应用.

Objective To examine the effect of ventilator bundle on prevention of ventilator associated pneumonia （VAP） in patients with malignant tumor. Methods In this prospective study, 147 patients with malignant tumor in intensive care unit were received ventilator intervention with the head position elevated 30 degree, daily＇ sedation vacation＇ done and daily readiness to extubation assessed, prevention for peptic ulcer disease and deep venous thrombosis taken. Compared with the hospitalized patients before the intervention,mechanical ventilation time and incidence of VAP were analyzed. Results Compared with the control group,after the administration of ventilator bundle, the incidence of VAP decreased slightly, mechanical ventilation time shortened and hospital stay in ICU reduced dramatically. Conclusions Ventilator bundle could significantly prevent the incidence of VAP in patients with malignant tumor.