机械通气患者预防呼吸机相关性肺炎的集束化护理

Effects of Cluster Care in Prevention of Ventilator-associated Pneumonia

目的探讨集束化护理措施在预防机械通气患者呼吸机相关性肺炎（ventilator-associated pneumonia，VAP）中的效果。方法回顾性分析2012年1—12月在湖州市中心医院重症医学科机械通气≥48h患者的临床资料，所有患者均采取呼吸道管理、抬高床头30°～45°、加强口腔护理、预防消化道溃疡和深静脉血栓等集束化护理措施。结果应用集束化护理措施后，216例患者中，发生VAP40例，发生率为18．52％，较常规护理干预明显降低。结论集柬化护理措施可明显降低机械通气患者VAP发生率，是预防和减少VAP的有效方法。

Objective To explore the effect of cluster care measures in prevention of the mechanical ventilation in patients with ventilator-associated pneumonia. Methods From January to December 2012 , the clinical data of 216 patients with mechanical ventilation more than 48h in our hospital were analyzed retrospectively. All patients were given cluster care, including respiratory management, elevation of the bed head （30°～45°） ,strengthening oral care ,the prevention of peptic ulcer and deep venous thrombosis. Results For all of the 216 patients, VAP occurred in 40 cases, the incidence of VAP was 18.52%, the incidence of VAP was significantly reduced. Conclusion Cluster care measures can significantly reduce the ventilatorassociated pneumonia incidence in the patients with mechanical ventilation and also is an effective method for the prevention and reduction of VAP.