综合护理措施对呼吸机相关性肺炎的预防效果分析

Analysis of the preventive effect of comprehensive nursing measures on ventilator-associated pneumonia

目的探讨综合护理措施对呼吸机相关性肺炎(VAP)的预防效果。方法对2007年1月～2012年4月在本院急症监护室内应用机械通气的252例患者进行回顾性分析,将2009年3月～2012年4月的126例给予综合护理措施的患者作为观察组,具体包括加强病房管理,加强呼吸机管理,加强人工气道管理以及加强基础护理等。另将2007年1月～2009年1月126例给予常规干预的患者做为对照组:传统方法湿化气管,每日向气管内滴入生理盐水3～5mL;常规口腔护理,2次/d;开放式吸痰等。观察并比较两组患者呼吸机相关性肺炎的发生情况。结果观察组呼吸机相关性肺炎的发生率为28.5%,对照组呼吸机相关性肺炎的发生率为66.7%,差异有统计学意义(P<0.05)。另外,观察组的机械通气天数以及住院时间均较对照组明显缩短,观察组优于对照组。二者相比具有统计学意义(P<0.05)。结论综合护理措施对呼吸机相关性肺炎具有很好的预防效果,值得在临床上推广实施。

Objective To discuss the preventive effect of comprehensive nursing measures on ventilatorassociated pneumonia（VAP）. Methods 126 cases of patients who were admitted into our hospital＇s ICU for using mechanical ventilation therapy were selected as observation group and treated with comprehensive measures,to be specific,strengthening the ward administration,the ventilator management, artificial airway management and basic nursing, etc. Another 126 cases patients were selected as control group and treated with routine interventions;Humidification of airway with traditional methods, instillationof 3-5 mL normal saline into airway daily, routine oral care（2 times/d） and open endotracheal suctioning were conducted.The occurrence of VAP of two groups were observed and compared. Results The VAP occurrence rate of observation group was 28.5%, while the control group was 66.7%,there was a significant difference between two groups（P 〈 0.05）.In addition,the time of mechanical ventilation and length of stay of observation group were superior and less than control group, there was a significant difference between two groups（P 〈 0.05）. Conclusion Comprehensive nursing measures has a good effect on VAP,it worth to be promoted into clinical therapy.