呼吸机集束干预策略对呼吸机相关性肺炎的影响

The research of the influence of ventilator buddle in preventing ventilator associated pneumonia.

目的：探讨呼吸机集束化干预策略在预防呼吸机相关性肺炎（VAP）中的影响。方法：采用回顾性研究方法,对2008年10月～2010年10月收住ICU的机械通气病人共286例进行集束化治疗与护理。所有病人采取抬高床头、每天“唤醒计划”、消化性溃疡的预防、深静脉血栓的预防等集束化干预策略。通过对体温、痰量和性状、血象、胸部X线片及下呼吸道细菌学检查监测,观察VAP的发生率及死亡率;取本院ICU2006年1月～2007年12月机械通气病人262例作为对照组。结果：机械通气病人集束化干预后,病人VAP的发生率较对照组有显著下降（P〈0.01）,死亡率较对照组下降（P〈0.05）。结论：集束化干预策略能有效降低VAP的发生。

Objective：To investigate the influence of ventilator buddle of care in preventing ventilator associated pneumonia（VAP）.Methods：286 patients with mechanical ventilation in ICU during October 2008 to October 2010 were enrolled in the preset retrospective study,All of the subjects were received head-of bed elevation,daily awaken plan,stress ulcer prevention,deep venous thrombosis prevention and other ventilator buddle.We recorded their body temperature,quantity and character of sputum,hemogram,sternum and lower respiratory tract bacteriology examination,the morbidity and mortality were observed.Another 262 mechanical ventilated patients with conventional care in the hospital from January 2006 to December 2007 were taken as control.Results：The morbidity and mortality of VAP of patients with mechanical ventilation was significantly decreased after ventilator buddle of care than those in control group.Conclusion：Ventilator buddle of care can effectively reduce the occur rate of VAP.