改良集束化管理预防小儿呼吸机相关性肺炎的分析与应用

目的比较采用改良集束化管理与传统集束化管理小儿呼吸机相关性肺炎的发生率。方法选择2016年3月至2018年3月在本院PICU机械通气的60例患儿作为观察组,采用改良集束化管理策略;选择2014年2月至2016年2月在本院PICU机械通气的58例患儿作为对照组,采用传统集束化管理策略。比较两组患儿呼吸机相关性肺炎的发生率,比较两组患儿平均机械通气时间及撤机后住院时间,并比较发生小儿呼吸机相关性肺炎细菌培养菌群分布情况。结果与对照组比较,观察组呼吸机相关性肺炎发生率明显低于对照组,观察组平均机械通气时间及入住PICU时间明显低于对照组,菌群分布情况亦有明显不同。结论改良集束化管理能够明显降低小儿呼吸机相关性肺炎发生率,减少机械通气时间及入住PICU时间。

Objective To compare the incidence of ventilator-associated pneumonia(VAP)in children with improved and traditional cluster management.Methods 60 children with mechanical ventilation in our hospital from March 2016 to March 2018 were selected as the observation group.The improved cluster management strategy was adopted.58 cases of mechanical ventilation in our hospital from February 2014 to February 2016 were selected as the control group.The traditional cluster management strategy was adopted.The incidence of ventilator-associated pneumonia was compared between the two groups.The mean time of mechanical ventilation and hospitalization after evacuation were compared between the two groups.The distribution of bacterial culture in children with ventilator associated pneumonia was compared.Results Compared with the control group,the incidence of ventilator-associated pneumonia in the observation group was significantly lower than that in the control group,the mean time of mechanical ventilation and PICU admission in the observation group were significantly lower than that in the control group,and the distribution of bacteria was also significantly different.Conclusion Improved cluster management can significantly reduce the incidence of ventilator-associated pneumonia in children,and reduce the time of mechanical ventilation and PICU admission.