综合性干预措施对呼吸机相关性肺炎的影响

Clinical observation of comprehensive intervention measures on ventilator associated pneumonia

目的观察综合性干预措施对呼吸机相关性肺炎的影响。方法将住院期间机械通气患者106例随机分为实验组和对照组。实验组通过人工鼻、密闭式吸痰、声门下吸引、优化营养供给、加强口腔护理等综合性干预措施预防呼吸机相关性肺炎。结果总VAP的发生率为34.9%,实验组(24.3%)低于对照组(75.7%),两组差异有统计学意义(P<0.05);总VAP患者病死率为43.2%,实验组为43.8%,对照组为56.2%,两组差异无统计学意义(P>0.05)。实验组平均机械通气时间、平均住ICU时间短于对照组,死亡率低于对照组,差异有统计学意义(P<0.05)。结论呼吸机相关性肺炎是引起院内感染的主要原因之一,可通过使用人工鼻、密闭式吸痰、声门下吸引、优化营养供给、加强口腔护理等综合性干预措施降低其发生,提高医疗质量。

Objective To obeserve the influence of comprehensive intervention on ventilator associated pneumonia （VAP） . Methods 106 patients on mechanical ventilation were randomly divided into experimental group and control group. Comprehensive intervention measures against VAP were taken in the experimental group, including applying artificial nose, suhglottie secretion drainage, optimizing nutrition, strengthening oral care, etc. Results The average incidence rate of VAP was 34. 9% as the data of experimental group （24. 3% ） was lower than the control group （75.7%） , with statistical difference （P 〈0. 05） ; the average fatality rate was 43.2% , the rates were 43.8% and 56. 2% in experimental group and the control group, respectively, with no significant difference （ P 〉 0. 05 ） . The median duration of mechanical ventilation and aver- age length of hospital stay in ICU was shorter than the control group with statistical difference. Conclusion VAP was one of the causes of nosocomial infection, which could be prevented through comprehensive intervention such as applying artificial nose, subglottic secretion drainage, optimizing nutrition, strengthening oral care, etc.