呼吸机集束化策略预防普外科术后患者呼吸机相关性肺炎的效果观察

Effect of ventilator bundle for prevention of ventilator associated pneumonia in patients after general surgery

目的探讨呼吸机集束化策略在普外科术后患者呼吸机相关性肺炎(VAP)预防中的作用。方法将普外科术后机械通气在48 h以上的患者112例,分为干预组58例及对照组54例。对照组按常规护理,干预组除实施常规护理外,实行集束化干预策略。采取抬高头部≥30°体位、每日唤醒并评估患者进行脱机实验,预防消化性溃疡、深静脉血栓等措施。分析两组机械通气时间及VAP发生率。结果干预组机械通气时间、VAP发生率明显低于对照组,差异有统计学意义(P<0.05)。结论在普外科术后患者机械通气治疗期间,实施呼吸机集束化干预措施有助于减少机械通气时间,降低VAP的发生,值得临床推广应用。

Objective To examine the effect of ventilator bundle for prevention of ventilator associated pneumonia （VAP） in patients after general surgery. Methods One hundred and twelve patients who just received general surgery and whose mechanical ventilation time was over 48 h were included in the study. They were assigned to intervention group （ n = 58） and control group （ n = 54）. The control group received conventional nursing and the intervention group received both the conventional nursing and bundle intervention, which included elevated position over 30 degrees, daily wakingup, assessment of extubation, prevention of peptic ulcer disease and deep venous thrombosis. Mechanical ventilation time and incidence of VAP were analyzed. Results The mechanical ventilation time and the incidence of VAP was obviously lower in the intervention group than the control group and the difference was statistically significant （P 〈 0.05）. Conclusion Ventilator bundle could significantly reduce mechanical ventilation and prevent the incidence of VAP in patients after general surgery. It is worthy of clinical application.