综合护理干预对降低ICU重症患者呼吸机相关性肺炎发生率的影响

Effect of Comprehensive Nursing Intervention on Reducing the Incidence of Ventilator-associated Pneumonia in ICU Patients

目的探讨在ICU重症患者中实施综合护理干预对降低呼吸机相关性肺炎发生率的影响。方法选取2018年11月至2020年12月医院收治的68例ICU重症患者,将其按照入住ICU时间进行分组,每组34例,对照组实施常规护理,研究组实施综合护理干预,对比两组呼吸机相关肺炎发生情况,测定两组护理前后的血气分析指标与炎性因子指标,观察两组体温恢复正常时间、机械通气时间、ICU住院时间、总住院时间,测定两组护理前后的心率与呼吸频率,调查两组护理质量评分情况与护理满意度。结果研究组呼吸机相关性肺炎发生率(5.88%)明显低于对照组(26.47%),呼吸机相关性肺炎发生时间明显比对照组晚,P<0.05。护理干预前,组间二氧化碳分压、氧分压、氧合指数对比,差异无统计学意义(P>0.05);护理干预后,研究组二氧化碳分压低于对照组,氧分压、氧合指数均高于对照组,差异有统计学意义(P<0.05)。护理干预前,组间降钙素原水平、C反应蛋白水平、白细胞计数对比,差异无统计学意义(P>0.05);护理干预后,研究组降钙素原水平、C反应蛋白水平、白细胞计数均低于对照组(P<0.05)。研究组体温恢复正常时间早于对照组,机械通气时间短于对照组,ICU住院时间以及总住院时间均比对照组短(P<0.05)。护理干预前,组间心率、呼吸频率变化对比,差异无统计学意义(P>0.05);护理后,研究组心率、呼吸频率变化情况均低于对照组(P<0.05)。研究组基础护理、护理态度、护理技术、人文关怀评分均高于对照组(P<0.05)。研究组总满意度高于对照组(P<0.05)。结论对于ICU重症患者而言,综合护理干预的实施可降低呼吸机相关性肺炎发生率,延缓呼吸机相关性肺炎的发生,改善血气分析指标,减轻炎性反应,促进患者恢复,提高护理质量,使患者对护理服务更加满意。

Objective To analyze the effect of comprehensive nursing intervention on reducing the incidence of ventilator-associated pneumonia in ICU patients.Methods From November 2018 to December 2020,68 patients with severe ICU were selected and divided into groups according to the time of ICU stay,with 34 cases in each group.The control group was given routine nursing care,and the study group was given comprehensive nursing intervention.The incidence of ventilator-associated pneumonia in the two groups was compared and analyzed.The blood gas analysis indexes and inflammatory factor indexes of the two groups before and after nursing were measured.The time of temperature return to normal,mechanical ventilation time,ICU hospitalization time and total hospitalization time of the two groups were observed.The heart rate and respiratory rate of the two groups before and after nursing were measured.The nursing quality score and nursing satisfaction of the two groups were investigated.Results The incidence of ventilator-associated pneumonia in the study group(5.88%)was significantly lower than that in the control group(26.47%),and the incidence of ventilator-associated pneumonia was significantly later than that in the control group,P<0.05.Before nursing intervention,there was no significant difference in carbon dioxide partial pressure,oxygen partial pressure and oxygenation index between groups(P>0.05).After nursing intervention,the partial pressure of carbon dioxide in the study group was lower than that in the control group,and the partial pressure of oxygen and oxygenation index were higher than those in the control group,and the difference was statistically significant(P<0.05).Before nursing intervention,there was no significant difference in the level of procalcitonin,C-reactive protein and white blood cell count between the groups(P>0.05).After nursing intervention,the levels of procalcitonin,C-reactive protein,and white blood cell count in the study group were lower than those in the control group(P<0.05).The time for body temperature to return to normal in the study group was earlier than that in the control group,the time for mechanical ventilation was shorter than that in the control group,and the ICU stay and total hospital stay were shorter than those in the control group(P<0.05).Before nursing intervention,there was no significant difference in the changes of heart rate and respiratory rate between groups(P>0.05).After nursing,the changes of heart rate and respiratory rate in the study group were lower than those in the control group(P<0.05).The scores of basic nursing,nursing attitude,nursing technology and humanistic care in the study group were higher than those in the control group(P<0.05).The total satisfaction of the research group was higher than that of the control group(P<0.05).Conclusion For ICU severe patients,the implementation of comprehensive nursing intervention can reduce the incidence of ventilator-associated pneumonia,delay the occurrence of ventilator-associated pneumonia,improve blood gas analysis indicators,reduce inflammatory reaction,and promote the recovery of patients.It is of great clinical value to improve the quality of nursing and make patients more satisfied with nursing services.