集束化护理在急性呼吸窘迫综合征俯卧机械通气患者中的应用

Application of cluster nursing in patients with acute respiratory distress syndrome prone mechanical ventilation

目的探讨集束化护理在急性呼吸窘迫综合征(ARDS)俯卧机械通气患者中的应用。方法选择2019年5月~2020年5月在九江学院附属医院行俯卧机械通气治疗的60例ARDS患者,依据随机数字表法分为对照组(30例)与观察组(30例)。对照组实施常规护理干预,在对照组的基础上观察组实施集束化护理干预,两组均干预1个月。比较两组干预前及干预后的血气指标;记录并比较两组的住院时间;统计比较两组干预期的非计划性拔管累计次数、并发症总发生率。结果干预后,两组的氧合指数(PaO2/FiO2)水平高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05);观察组的住院时间短于对照组,干预期间的非计划性拔管累计次数少于对照组,差异均有统计学意义(P<0.05);干预期间,观察组的并发症总发生率与对照组比较,差异无统计学意义(P>0.05)。结论集束化护理应用于ARDS俯卧机械通气患者的效果较为显著,在改善患者的血气指标,缩短住院时间,减少非计划性拔管累计次数效果较好。

Objective To explore the application of cluster nursing in patients with acute respiratory distress syndrome(ARDS)prone mechanical ventilation.Methods From May 2019 to May 2020,60 patients with ARDS who were treated with prone mechanical ventilation in the Affiliated Hospital of Jiujiang University were selected and divided into the control group(30 cases)and the observation group(30 cases)according to the random number table method.The control group implemented routine nursing intervention,and the observation group implemented clustered nursing intervention on the basis of the control group.Both interventions were for 1 month.Compare the blood gas indexes of the two groups before and after the intervention(intervention for 1 month);record and compare the hospital stay of the two groups;statistically compare the cumulative number of unplanned extubation and the total incidence of complications during the intervention of the two groups.Results After the intervention,the oxygenation index(PaO2/FiO2)levels of the two groups were higher than those before the intervention,and the observation group was higher than the control group,the differences were statistically significant(P<0.05).The observation group′s hospital stay was shorter than the control group,the cumulative number of unplanned extubation during the intervention period was less than that in the control group,and the differences were statistically significant(P<0.05).During the intervention period,the total complication rate of the observation group was compared with the control group,and the difference was not statistically significant(P>0.05).Conclusion The effect of clustered nursing in patients with ARDS prone mechanical ventilation is more significant,and it is effective in improving patients′blood gas indicators,shortening the hospital stay,and reducing the cumulative number of unplanned extubations.