新生儿呼吸窘迫综合征在行持续性通气中的综合护理应用分析

Analysis of comprehensive nursing application of neonatal respiratory distress syndrome in continuous ventilation

目的探究综合护理在行持续通气的新生儿呼吸窘迫综合征(NRDS)患儿的应用价值分析。方法按标准选取2015年1月至2016年12月入住新生儿重症监护室的NRDS患儿74例,以随机数字表法将74例患儿分为试验组和对照组,每组37例。两组患儿入院后均采用肺泡表面活性物质替代疗法+通气疗法+液体管理疗法的治疗方案;对照组采用传统的护理措施,试验组选择综合护理,包括浅层吸痰、叩击震颤排痰、碳酸氢钠冲洗式口腔护理、双人配合翻身法。比较两组患儿吸痰前后的血氧饱和度(SpO_2)和二氧化碳分压(PaCO_2),比较机械通气时间、住院时间及呼吸机相关性肺炎(VAP)发生率、病死率。结果试验组吸痰后SpO_2高于对照组,PaCO_2明显低于对照组,差异均有统计学意义(P<0.05);试验组机械通气时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。试验组VAP发生率为8.11%,对照组为16.22%,试验组病死率为2.70%,对照组为8.11%,对照组VAP发生率、病死率均高于试验组,但差异无统计学意义(P>0.05)。结论综合护理方法取得了积极的效果,NRDS患儿行持续通气中的综合护理模式明显优于传统的护理模式,值得推广。

Objective To analyze the application value of comprehensive nursing care in children with neonatal respiratory distress syndrome treatment of continuous ventilation.Methods According to the standard selected from January 2015 to December 2016 children admitted to children with intensive care in 74 cases,the random number table method used in 74 cases of children which were divided into experimental group and control group,each group with 37 cases.Two groups of patients were treated with alveolar surfactant replacement therapy,ventilation therapy and liquid management therapy treatment.The two groups of basic care methods,the control group using traditional nursing measures,the experimental group to choose comprehensive care,including shallow negative pressure suction,percussion tremor expectoration,sodium bicarbonate flushing oral care,double with the turning method were considered.The SpO_2and PaCO_2 before and after suction was compared between the two groups,and the incidence of morbidity, hospitalization and ventilator-associated pneumonia（VAP） were compared.Results The scores of PaCO_2 in the experimental group were significantly lower than those in the control group（P 0.05）,and the difference was statistically significant（P 0.05）.The ventilation time and hospitalization time of the test group were shorter than those of the control group,the difference was statistically significant（P0.05）.The incidence of VAP was 8.11% in the experimental group and 16.22% in the control group,which was significantly higher than that in the control group（P0.05）.The mortality rate was 2.70% in the experimental group and 8.11% in the control group,but the difference was not statistically significant（P 0.05）.Conclusions Comprehensive nursing methods to achieve a positive effect,continuous ventilation under the comprehensive nursing model is significantly better than the traditional nursing model,it is worth promoting.