集束化护理干预对ICU重型颅脑损伤机械通气患者呼吸机相关性肺炎的治疗效果

Effect of cluster nursing intervention on treatment efficacy of ventilator associated pneumonia in patients with severe traumatic brain injury by mechanical ventilation in ICU

目的研究集束化护理干预对ICU重型颅脑损伤机械通气患者呼吸机相关性肺炎及治疗效果的影响。方法选取本院ICU病房收治的重型颅脑损伤患者120例,按照不同护理方式分成对照组与观察组各60例。对照组采用常规护理干预,观察组采用集束化护理干预。观察2组患者的治疗效果,比较呼吸相关性肺炎等并发症发生情况。结果观察组通气不良、VAP、胃肠胀气、损伤压迫等并发症发病率低于对照组(P<0.05),患者机械通气时间及ICU监护时间少于对照组(P<0.05);2组患者在干预前APACHE评分比较无差异(P>0.05);干预后观察组APACHE评分低于对照组(P<0.05)。结论对ICU重型颅脑损伤机械通气患者予以集束化护理干预治疗,能降低呼吸机相关性肺炎的发病率,提高患者的临床治疗疗效,临床上值得推广。

Objective To investigate the effect of cluster nursing intervention on treatment efficacy of ventilator associated pneumonia in patients with severe traumatic brain injury by mechanical ventilation in ICU. Methods A total of 120 patients with severe craniocerebral injury in ICU were divided into control group （60 cases） and observation group （60 cases） according to nursing method. Patients in the control group were treated with routine nursing and the observation group treated with cluster nursing. The treatment effect and complications such as respiratory associated pneumonia of two groups were observed and compared. Results The rates of poor ventilation, VAP, flatulence, oppression and other complications in the observation group were significantly lower than that in the control group （P 〈 0.05 ）. The mechanical ventilation time and ICU monitoring time of observation group were significantly less than that in the control group （P 〈 0.05 ）. Before intervention, the APACHE scores showed no significant difference between two groups （P 〉 0.05） , after intervention, the APACHE scores in observation group was significantly lower than that in the control group （P 〈 0. 05 ）. Conclusion Cluster nursing intervention can reduce the incidence of ventilator associated pneumonia and improve the clinical efficacy for ICU severe brain injury patients with mechanical ventilation. So it is worthy of widely spread in clinical practice.