呼吸机集束化策略预防神经外科术后患者呼吸机相关性肺炎的效果观察

Prevention of Ventilator-associated Pneumonia in Patients After Neurosurgery by Ventilator Cluster Strategy

目的:探讨呼吸机集束化策略预防神经外科术后患者呼吸机相关性肺炎的临床效果。方法:研究对象为本院2018年9月~2019年9月72例神经外科手术后机械通气时间超过48h的患者,所有患者均开展气管插管呼吸机辅助呼吸。应用SPSS20.0软件将其分为研究组和对照组,分别给予呼吸机集束化策略和常规策略,对比两组患者的呼吸机相关性肺炎发生率、再插管发生率、机械通气时间和ICU住院时间。结果:研究组和对照组患者呼吸机相关性肺炎发生率分别为11.11%(4例)和27.78%(10例),组间差异显著(P<0.05);研究组和对照组患者再插管发生率分别为5.56%(2例)和8.33%(3例),组间差异不显著(P>0.05);研究组机械通气时间和ICU住院时间分别为(14.94±3.44)h和(10.42±3.02)h,均显著短于对照组患者的(18.57±3.78)h和(16.90±3.60)h(P<0.05)。结论:对神经外科术后患者应用呼吸机集束化策略可以有效降低呼吸机相关性肺炎的发生率,缩短患者的机械通气时间和ICU住院时间。

Objective:In order to explore the clinical effect of ventilator-associated pneumonia(VAP)prevention in neurosurgery patients.Methods:From September 2018 to September 2019,72 patients who had mechanical ventilation for more than 48 hours after neurosurgery were enrolled in the study.All patients were given endotracheal intubation and ventilator-assisted breathing.SPSS20.0 software was used to divide the patients into the study group and the control group.They were given the intensive strategy and the routine strategy respectively.The incidence of ventilator associated pneumonia,the incidence of re intubation,the mechanical ventilation time and the hospitalization time in ICU were compared.Results:The incidence of ventilator-associated pneumonia were 11.11%(4 cases)and 27.78%(10 cases)in the two groups,with significant difference(P<0.05);the incidence of re intubation were 5.56%(2 cases)and 8.33%(3 cases)in the two groups,with no significant difference(P>0.05);the duration of mechanical ventilation and ICU hospitalization were(14.94±3.44)h and(10.42±3.02)h significantly shorter than those in the control group(18.57±3.78)h and(16.90±3.60)h(P<0.05).Conclusion:The application of ventilator intensive strategy in neurosurgery patients can effectively reduce the incidence of ventilator-associated pneumonia,shorten the time of mechanical ventilation and ICU hospitalization.