集束化护理在极低出生体质量儿机械通气中的应用

Application of care bundles for very low birth weight infants with mechanical ventilation

目的探讨集束化护理在极低出生体质量儿机械通气中的应用。方法选取2015年5月—2016年4月收治的行机械通气的极低出生体质量儿35例为对照组,2016年5月—2017年4月收治的行机械通气的极低出生体质量儿35例为观察组。70例患儿中,除家属放弃6例、死亡4例外,其余60例均顺利脱机并治愈出院,其中观察组31例,对照组29例。对照组采用常规护理,观察组采用集束化护理干预,包括严格执行手卫生制度及无菌操作、体位管理、口腔及皮肤管理、气管插管管理、呼吸道管理、密闭式吸痰、胃管管理、撤机管理等方法。观察2组患儿机械通气时间、住院天数、住院费用及每天体质量增长率。结果观察组患儿机械通气时间、住院天数、住院费用均少于对照组(P<0.05),观察组患儿每天体质量增长率高于对照组(P<0.05)。结论对极低出生体质量儿实施有效的集束化护理干预可在一定程度上减少机械通气时间,缩短住院天数,减少住院费用,促进体质量增长。

Objective To evaluate the nursing care bundles for very lowbirth weight（VLBW） infants with mechanical ventilation. Methods To tally 60 VLBW infants with mechanical ventilation were assigned to the control group（ n = 29,between May,2015 and April,2016） and the observation group（ n = 31,between May,2016 and April,2017） according to the admission sequence. The control group was given routine care during mechanical ventilation. The nursing care bundles including hand hygiene,sterile operation,position management,oral and skin care and management on trachea cannula,sputumsuction,sto mach tube,withdrawfrom ventilatory support were carried out in the observation. The duration of ventilatory support,length of stay,hospitalization costs and daily growth rate of bodyweight were recorded and compared between two groups. Results There was a shorter duration of ventilatory support,a shorter length of stay and a lower hospitalization cost in the observation group than that of controls,respectively（ P〈0. 05）. The infants in the observation group gained a higher daily growth rate of bodyweight compared with those in the control group（ P〈0. 05）. Conclusion The application of care bundles is potentially effective to reduce the duration of ventilatory support and promote the growth of bodyweight in VLBW infants with mechanical ventilation.