综合气道干预预防呼吸衰竭患儿呼吸机相关性肺炎的效果分析

Effect of Comprehensive Airway Intervention on Prevention of Ventilator-associated Pneumonia in Children with Respiratory Failure

目的:探讨综合气道干预预防呼吸衰竭患儿呼吸机相关性肺炎(VAP)的应用效果。方法:选取2018年6月-2019年5月本院收治的呼吸衰竭患儿80例。按照随机数字表法将其分为观察组和对照组,每组40例。对照组给予常规护理,观察组给予对照组基础上行综合气道干预。比较两组患儿干预前后生命体征情况、炎症指标,并比较两组机械通气时间、住院时间临床症状缓解时间及VAP发生情况。结果:干预后,两组RR、HR、WBC、hs-CRP均较干预前降低,且观察组RR、HR、WBC、hs-CRP均低于对照组,差异均有统计学意义(P<0.05)。干预后,两组SaO2、MAP均较干预前升高,且观察组SaO2、MAP均高于对照组,差异均有统计学意义(P<0.05)。干预后,观察组的机械通气时间、住院时间均短于对照组,差异均有统计学意义(P<0.05)。观察组的VAP发生率为5.00%,低于对照组的20.00%,差异有统计学意义(P<0.05)。干预后,观察组体温退热时间、气促缓解时间、咳嗽缓解时间、肺部啰音消失时间均明显短于对照组,差异均有统计学意义(P<0.05)。结论:综合气道干预能够有效改善患儿生命体征状态,提高血氧饱和度和平均动脉压,有效改善炎症水平,降低VAP发生率,缩短症状缓解时间,值得在临床推广。

Objective:To investigate the effect of comprehensive airway intervention on prevention of ventilator-associated pneumonia(VAP)in children with respiratory failure.Method:Eighty children with respiratory failure admitted to our hospital from June 2018 to May 2019 were selected.According to the random number table method,they were divided into observation group and control group,40 cases in each group.The control group was given routine nursing,the observation group was given basic uplink comprehensive airway intervention.The vital signs and inflammatory indexes of the two groups were compared before and after the intervention,and the mechanical ventilation time,hospitalization time,clinical symptom relief time and VAP incidence were compared between the two groups.Result:After the intervention,RR,HR,WBC and hs-CRP in the two groups were lower than those before the intervention,and the RR,HR,WBC and hs-CRP in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After intervention,SaO2 and MAP of the two groups were higher than those before intervention,and SaO2 and MAP of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).After the intervention,the mechanical ventilation time and hospitalization time of the observation group were shorter than those of the control group,the differences were statistically significant(P<0.05).The incidence of VAP in the observation group was 5.00%,which was lower than 20.00%in the control group,the difference was statistically significant(P<0.05).After intervention,the duration of hypothermia,remission of shortness of breath,remission of cough,and disappearance of rhonchus in the lungs in the observation group were significantly shorter than those in the control group,with statistically significant differences(P<0.05).Conclusion:Comprehensive airway intervention can effectively improve the vital signs of children,improve blood oxygen saturation and mean arterial pressure,effectively improve the level of inflammation,reduce the incidence of VAP,shorten the time of symptom relief,which is worthy of clinical promotion.