以Omaha系统为基础的个案管理模式在ICU重症呼吸衰竭患者中的应用

application of Omaha system-based case management model in ICU patients with severe respiratory failure

目的探讨以Omaha系统为基础的个案管理模式对ICU重症呼吸衰竭机械通气患者预后的影响。方法2014年6月—2016年6月选取本院ICU收治的行呼吸机辅助通气的84例重症呼吸衰竭患者，根据随机数字表将患者分为观察组（n=42）及对照组（n=42），对照组通气期间行常规性护理，观察组在对照组基础上以Omaha系统为基础实施个案管理护理，比较两组患者预后及并发症情况。结果观察组干预后血乳酸水平、急性生理学及慢性健康评估系统（APACHEⅡ）评分、呼吸机依赖、呼吸机相关性肺炎（VAP）、再插管率均低于对照组，机械通气时间、住ICU时间及总住院时间均短于对照组，差异有统计学意义（P〈0.05）。结论以Omaha系统为基础的个案管理模式能有效改善ICU重症呼吸衰竭机械通气患者预后，缩短患者住院时间，提高患者满意度。

Objective To explore the effects of Omaha system-based case management model on the prognosis of ICU patients with severe respiratory failure.Methods Totally 84 cases of patients with severe respiratory failure in our hospital from June 2014 to June 2016 were selected and divided into the observation group （n = 42） and the control group （n = 42） according to random number table. Patients in the control group were given routine nursing during ventilation, while patients in the observation group were given Omaha system-based case management model. The prognosis and complications of patients in two groups were compared.Results The level of blood lactate, the scores of acute physiology and chronic health evaluation system （ APACHEⅡ ） , and the rates of ventilator-dependent, ventilator associated pneumonia （VAP） and reintubation were all lower than the data in the control group, while the time of mechanical ventilation and staying in ICU, as well as the total hospitalization time were all shorter than the time in the control group （P〈0.05）. Conclusions The Omaha system-based case management model can effectively improve the prognosis of ICU mechanically ventilated patients with severe respiratory failure, shorter the hospitalization time, and improve patient satisfaction.