集束化护理在预防脑卒中鼻饲患者吸入性肺炎中的应用效果

Application Effect of Cluster Nursing in Prevention of Aspiration Pneumonia in Patients with Nasal Feeding for Stroke

目的探讨集束化护理在预防脑卒中鼻饲患者吸入性肺炎中的临床应用效果。方法选择2018年2月—2019年10月该院收治的缺血性脑卒中实施鼻饲流质治疗患者80例,随机分为两组,各40例。对照组实施常规神经内科护理,观察组实施该研究集束化护理管理,比较两组干预后肺部感染综合评分得分;比较两组误吸及吸入性肺炎整体发生情况;统计两组护理临床干预效果。结果干预后观察组肺部感染综合评分得分各分项及总分分别为体温(0.3±0.1)分,白细胞计数(0.4±0.1)分,气体交换指数(0.5±0.1)分,分泌物评分(0.3±0.1)分,总分(1.5±0.1)分,均显著低于对照组的(1.5±0.2)分,(1.6±0.3)分,(1.4±0.1)分,(1.5±0.2)分,(6.1±0.2)分,差异有统计学意义(t=33.941、24.000、40.249、33.941、130.108,P<0.05),观察组发生误吸及吸入性肺炎整体比例为5.0%,显著低于对照组的35.0%,差异有统计学意义(χ^2=9.453,P<0.05),观察组总有效率为95.0%,显著高于对照组的62.5%,差异有统计学意义(χ^2=10.756,P=0.001)。结论针对缺血性脑卒中实施鼻饲流质时可能发生的误吸实施集束化护理,能有效的降低肺部感染几率,减少误吸及吸入性肺炎发生率,提高临床治疗效果。

Objective To explore the clinical application effect of cluster nursing in the prevention of aspiration pneumonia in patients with nasal feeding for stroke.Methods Eighty patients with ischemic stroke treated in our hospital from February 2018 to October 2019 underwent nasal feeding fluid therapy were randomly divided into two groups,each with 40 cases.The control group was given routine neurology nursing,and the observation group was implementing the cluster nursing management of this study,comparing the two groups'comprehensive score of lung infection after intervention;comparing the overall incidence of aspiration and aspiration pneumonia in the two groups;counting the clinical intervention effects of the two groups of nursing.Results After the intervention,the score and total score of the pulmonary infection comprehensive score of the observation group were body temperature(0.3±0.1)points,white blood cell count(0.4±0.1)points,gas exchange index(0.5±0.1)points,and secretion score(0.3±0.1)points,the total score(1.5±0.1)points,significantly lower than that of the control group(1.5±0.2)points,(1.6±0.3)points,(1.4±0.1)points,(1.5±0.2)points(6.1±0.2)points(t=33.941,24.000,40.249,33.941,130.108,P<0.05),the overall proportion of aspiration and aspiration pneumonia in the observation group was 5.0%,significantly lower than 35.0%in the control group,the difference was statistically significant(χ^2=9.453,P<0.05),the total effective rate of the observation group was 95.0%,significantly higher than 62.5%of the control group,the difference was statistically significant(χ^2=10.756,P=0.001).Conclusion The implementation of cluster nursing for the aspiration of nasal feeding fluid during ischemic stroke can effectively reduce the chance of lung infection,reduce the incidence of aspiration and aspiration pneumonia,and improve the clinical treatment effect.