集束化护理干预对ICU呼吸机相关性肺炎的预防效果

Preventive effect of cluster nursing intervention on the prevention of ventilator-associated pneumonia in ICU patients

目的探讨集束化护理干预对重症监护科(ICU)呼吸机相关性肺炎(VAP)的预防效果,以总结机械通气患者的有效护理措施。方法选择深圳市龙华区人民医院重症医学科于2016年3月至2018年8月期间收治的300例机械通气治疗患者为研究对象,根据随机数表法分为对照组和观察组,每组150例,对照组予常规护理干预,观察组则给予集束化护理干预,比较两组患者的机械通气时间、住ICU时间及VAP发生率,同时记录VAP患者的致病菌。结果观察组患者的VAP发生率为16.67%,明显低于对照组的28.00%,机械通气时间、ICU住院时间分别为(9.29±3.56) d、(11.25±3.37) d,明显少于对照组的(11.37±4.27) d、(12.36±3.58) d,差异均有统计学意义(P<0.05);VAP病原菌前三位依次为耐甲氧西林金黄色葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌。结论集束化护理干预可有效预防ICU机械通气患者呼吸机相关性肺炎的发生,进而减少机械通气时间及住ICU时间,对促进患者的康复有利。

Objective To explore the preventive effect of cluster nursing intervention on the prevention of ventilator-associated pneumonia (VAP)in Intensive Care Unit (ICU),so as to summarize the effective nursing measures for patients with mechanical ventilation.Methods A total of 300 patients with mechanical ventilation,who treated in Department of Intensive Care Unit,Shenzhen Longhua District People's Hospital from March 2016 to August 2018,were selected and divided into the observation group and the control group according to random number table method,with 150 patients in each group.The control group was given routine nursing intervention,while the observation group was given cluster nursing intervention.The incidence of VAP,dura.tion of mechanical ventilation,and ICU stay of the two groups were compared.Meanwhile,the pathogenic bacteria in VAP patients were also recorded.Results The incidence of VAP in the observation group was 16.67%,which was significantly lower than 28.00% in the control group,and the duration of mechanical ventilation and ICU stay in the observation group were (9.29±3.56)d,(11.25±3.37)d,respectively, which were significantly less than corresponding (11.37±4.27)d,(12.36±3.58)d in the control group (All,P<0.05).The first three VAP pathogens were methicillin-resistant resistant Staphylococcus aureus,Pseudomonas aeruginosa and Klebsiella pneumoniae.Conclusion Cluster nursing intervention can effectively prevent the occurrence of ventilator-associat-ed pneumonia in patients with mechanical ventilation in ICU,and then reduce the duration of mechanical ventilation and stay in ICU,which is beneficial to the rehabilitation of patients.