综合干预降低重症监护病房呼吸机相关性肺炎发生率的临床观察

Clinical observation of comprehensive intervention to reduce ventilator-associated pneumonia in intensive care unit

目的探讨综合干预对重症监护病房呼吸机相关性肺炎的影响。方法将2015年1月—2016年6月实施综合干预的机械通气患者42例作为观察组,2013年1月-2014年12月常规处理的机械通气患者40例作为对照组,对照组实施呼吸机常规处理,观察组实施综合干预:加强业务培训、呼吸管路管理、清洁口腔、鼻饲管理、心理支持、营养支持、药物合理使用、防止胃管反流和误吸、间歇镇静与脱机评估。结果观察组呼吸机相关性肺炎发生率14.29%、机械通气时间(9.23±2.23)d、住监护病房(11.34±3.27)d,低于对照组的35.00%、(13.45±3.21)d、(15.34±4.07)d;满意度95.24%,高于对照组的85.00%,差异均有统计学意义(P<0.05)。结论综合干预为主动预防措施,有针对性和目的性,有助于降低呼吸机相关性肺炎发生率,从而缩短机械通气和住监护病房时间,提高治疗效果。

Objective To investigate the effect of comprehensive intervention onventilatorassociated pneumonia in intensive care unit. Methods From January 2015 to June 2016. The implementation of comprehensive intervention in patients with mechanical ventilation 42 eases asthe observation group,from January 2013 to December 2014 the conventional treatment patients 40 cases as control group, conventional treatment grou received ventilator control, the observation group received comprehensive intervention tostrengthen business training, breathing management, clean mouth, nasal feeding management, psychological support, nutritional support, rational drug use, to prevent reflux and aspiration,intermittent sedation ,offline evaluation.Results The observation group ventilator-associatedpneumonia was 14.29%, mechanical ventilation （9.23 ± 2.23） days, staying ICU （11.34 ± 3.27） lower than control group35.00%, （13.45 ±3.21） days, （15.34 ±4.07） days; satisfaction 92.54% higher than control group 85.00% （P〈0.05）. Concision The comprehensive intervention is targeted and purposeful which can reduce the incidence of pneumonia, improve the quality.