失效模式与效应分析对重症监护室中行呼吸机辅助治疗重症肺炎患者的应用价值

Application value of failure mode and effects analysis in severe pneumonia patients undergoing assisted ventilation in intensive care unit

目的探讨基于失效模式与效应分析(FMEA)的护理干预对在重症监护室(ICU)中行呼吸机辅助治疗重症肺炎患者的应用价值。方法回顾性分析2018年7月至2020年6月在武警重庆总队医院ICU接受呼吸机辅助治疗的86例重症肺炎患者的临床资料,根据不同的护理方法分为观察组与对照组,每组43例。对照组患者接受综合护理,观察组患者在综合护理的基础上加用基于FMEA的护理干预。比较2组患者的肺炎治疗总有效率、一般治疗情况、血气分析指标、疾病恢复情况,以及并发症发生情况。结果观察组的肺炎治疗总有效率较对照组高(P<0.05),呼吸机使用时间和ICU住院时间均较对照组短(P均<0.05)。干预3个月后,观察组的动脉血二氧化碳分压(PaCO_(2))水平较对照组低(P<0.05),动脉血氧分压(PaO_(2))水平较对照组高(P<0.05);2组的急性生理与慢性健康评估Ⅱ(APACHEⅡ)评分均较同组干预前降低(P均<0.05),且观察组的APACHEⅡ评分较对照组低(P<0.05)。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ICU中行呼吸机辅助治疗的重症肺炎患者采用基于FMEA的护理干预能有效提高护理效果,调节患者的血气分析指标,促进其通气,加快其康复。

Objective To explore the application value of nursing intervention based on failure mode and effects analysis(FMEA)in patients with severe pneumonia undergoing assisted ventilation in the intensive care unit(ICU).Methods The clinical data of 86 patients with severe pneumonia undergoing assisted ventilation in the ICU of Chongqing Armed Police Corps Hospital from July 2018 to June 2020 were retrospectively analyzed.They were allocated into an observation group and a control group accorded to different nursing methods,each with 43 cases.The control group received comprehensive nursing,and the observation group received FMEA-based nursing intervention on the basis of comprehensive nursing.The overall response rate of pneumonia treatment,general treatment,blood gas indicators,disease recovery,and complications were compared between the two groups.Results The overall response rate of pneumonia treatment in the observation group was higher than that in the control group(P<0.05),and the duration of ventilator use and ICU length of stay were shorter than those in the control group(both P<0.05).After 3 months of intervention,the arterial partial pressure of carbon dioxide(PaCO_(2))in the observation group was lower than that in the control group,and the arterial partial pressure of oxygen(PaO_(2))was higher than that in the control group(both P<0.05).The acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores of the two groups were lower than those before intervention(both P<0.05),and the APACHEⅡscores of the observation group were lower than those of the control group(P<0.05).There was no significant difference in the total incidence of complications between the observation group and the control group(P>0.05).Conclusion Nursing intervention based on FMEA can effectively improve the nursing effect,regulate the blood gas indicators,promote the ventilation,and accelerate the recovery of severe pneumonia patients undergoing assisted ventilation in the ICU.