严重腹腔感染腹腔开放患者机械通气期间VAP的预防

Prevention of VAP for serious intra-abdominal infection and abdominal open patients with mechanical ventilation

目的通过对严重腹腔感染腹腔开放患者机械通气期间采取相应的护理措施,预防呼吸机相关性肺炎(VAP)的发生。方法做好专职的气道护理,实行良好的手部卫生,每天给患者抬高床头,做好口腔护理尤其是气管插管患者的口腔护理,帮助和协助患者早期活动,使用梯度治疗装置来防止静脉血栓的形成,做好肠内营养的护理—肠内营养管应超过幽门,营养液由营养泵持续输入等护理预防措施。结果有效的减少了患者VAP的发生率,提高了救治成功率。结论严重腹腔感染腹腔开放的患者机械通气期间VAP发生率高,通过有效的护理预防措施可以减少其发生率。

Objective To explore appropriate nursing interventions to prevent the occurrence of VAP during the period of mechanical ventilation therapy of patients with severe intra-abdominal infection underwent open abdomen.Methods The following preventive measures have been taken： give full-time professional airway care;practice good hand hygiene;raise the head of the bed every day;take good oral care,especially for the patients with tracheal intubation;help patients to do some activities at early stage;use a gradient treatment device to prevent venous thrombosis;provide good enteral nutrition care-the end of enteral nutrition feeding tube should pass the pylorus of stomach,and nutrition fluid is pumped in continuously.Results The incidence of VAP was reduced and the cure rate was improved.Conclusion The high incidence of VAP,which happens in the period of mechanical ventilation therapy of patients with severe intra-abdominal infection underwent open abdomen,could be reduced by appropriate nursing interventions.