巨细胞病毒肺炎患者实行无创通气的监测与护理观察

Clinical nursing observation of patients with cytomegalovirus pneumonia using noninvasive ventilation in ICU

目的 对入住重症监护室（ICU）接受无创通气的巨细胞病毒肺炎（CMV）患者,通过监测护理,为临床相关应用提供证据.方法 2010年1月-2014年5月入住我院ICU病房接受无创通气的巨细胞病毒肺炎患者共计96例,常规应用抗病毒、免疫抑制剂及肠内外营养支持等综合治疗措施,在应用呼吸机期间对患者行心电监测及呼吸机管道护理,并积极预防及护理患者的不良反应.结果 96例患者中72例经无创通气治疗后好转出院,治疗有效率为69.1％;例患者在行无创通气后需进一步行有创呼吸机通气治疗,其中11例治愈出院,13例死亡.呼吸机治疗期间共有42例患者出现胃肠胀气者16例,面部皮肤压迫损伤28例,气胸者4例,皮下气肿者3例,鼻黏膜干燥、糜烂、出血者36例,刺激性结膜炎者2例.结论 在患者接受无创正压通气期间做好患者相关监测及护理是确保患者接受无创通气并确保通气成功与否的重要因素,通过正确积极的护理可以有效的减少患者接受呼吸机治疗期间出现的相关并发症并能有效的提高患者的治疗疗效.

Objective To provide evidence for clinical application through monitoring the nursing care of patients who accept the treatment of no CMV pneumonia,Methods 96 patients with cytomegalovirus pneumonia were selected in ICU ward of our hospital from January,2010 to May,2014.routine use are including antiviral,immunosuppressive drugs and enteral and parenteral nutritional support and other comprehensive treatment measures,in the application of respirator of patients during ECG monitoring and ventilator tube nursing,and adverse reaction of active prevention and nursing care of patients.Results 6 cases improved in 72 patients with noninvasive ventilation after treatment,the effective rate of treatment was 69.1% ; cases of patients undergoing noninvasive ventilation after further invasive ventilator therapy,of which 11 cases were cured,13 cases died.Ventilator treatment during a total of 42 patients with gastrointestinal flatulence in 16 cases,28 cases of facial skin compression injury,4 cases of pneumothorax,subcutaneous emphysema in 3 cases of nasal mucosa dry,erosion,bleeding in 36 cases,2 cases of irritative conjunctivitis.Conclusions When the patients receiving noninvasive positive pressure ventilation,making the relevant monitoring of patients and nursing is to ensure that patients receiving noninvasive ventilation is an important factor to ensure the success of the ventilation,through the correct active nursing can effectively reduce the patients undergoing ventilator therapy related complications occurred during and can effectively improve the curative effect in the treatment of patients.