集束化护理干预对重症监护病房气管插管患儿咽喉部应激状况及血流动力学稳定性的影响

Effects of Cluster Nursing Intervention on Throat Stress and Hemodynamic Stability of Children with Endotracheal Intubation in Intensive Care Unit

目的:探究集束化护理干预对重症监护病房气管插管患儿咽喉部应激状况及血流动力学稳定性的影响。方法:选取2019年1月—2020年12月泰安市妇幼保健院收治的96例重症监护病房接受气管插管患儿作为研究对象,按照随机分配法分为对照组和观察组,每组各48例。对照组采用常规护理干预,观察组采用集束化护理干预。对比两组患儿相关时间(气管插管时间、ICU住院时间、总住院时间)、咽喉部应激状况、血流动力学稳定性[收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、血氧浓度(SpO_(2))水平]、气管插管相关并发症发生率[呼吸机相关性肺炎(VAP)、谵妄、气道损伤]、生活质量评分。结果:观察组患儿气管插管时间、ICU住院时间以及总住院时间均短于对照组,差异有统计学意义(t=7.586、11.675、10.667,P<0.05)。观察组患儿咽喉水肿持续时间短于对照组,差异有统计学意义(t=13.278、20.869、12.324、18.492,P<0.05)。护理后观察组患儿SBP、DBP、MAP、HR水平低于对照组,差异有统计学意义(t=14.526、8.746、18.256、14.291,P<0.05);两组患儿SpO_(2)水平比较,差异无统计学意义(t=0.654,P>0.05)。观察组患儿气管插管相关并发症发生率低于对照组,差异有统计学意义(χ^(2)=4.360,P<0.05)。观察组患儿生活质量评分高于对照组,差异有统计学意义(t=7.814、8.466、10.602、9.108,P<0.05)。结论:重症监护病房气管插管患儿行集束化护理干预,对患儿咽喉部应激状况、血流动力学稳定性具有明显作用,且患儿恢复速度快,生活质量改善明显。

Objective: To explore the effect of cluster nursing intervention on throat stress and hemodynamic stability of children with endotracheal intubation in intensive care unit. Methods: From January 2019 to December 2020, 96 children who received tracheal intubation in the hospital from January 2019 to December 2020 were selected as the research subjects, and divided into the control group and the observation group according to the random allocation method, with 48 cases in each group. The control group received routine nursing intervention, while the observation group received cluster nursing intervention. The relative time(tracheal intubation time, ICU hospitalization time, total hospitalization time), throat stress status, hemodynamic stability(systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial pressure [MAP], heart rate [HR], blood oxygen concentration[SpO_(2)] level), incidence of complications related to tracheal intubation(ventilator-associated pneumonia [VAP], delirium, airway injury), and quality of life score were compared between the two groups. Results: The duration of tracheal intubation, ICU stay and total stay in the observation group were shorter than those in the control group, and the differences were statistically significant(t=7.586, 11.675, 10.667, P<0.05). The duration of laryngeal edema in the observation group was shorter than that in the control group, and the difference was statistically significant(t=13.278, 20.869, 12.324, 18.492, P<0.05). After nursing, the levels of SBP,DBP, MAP and HR in the observation group were lower than those in the control group, and the difference was statistically significant(t=14.526, 8.746, 18.256, 14.291, P<0.05). There was no statistically significant difference in SpO_(2)2levels between the two groups(t=0.654, P>0.05). The incidence of complications related to tracheal intubation in the observation group was lower than that in the control group, and the difference was statistically significant(χ^(2)=4.360, P<0.05). The quality of life score of the observation group was higher than that of the control group, and the difference was statistically significant(t=7.814, 8.466, 10.602,9.108, P<0.05). Conclusion: The cluster nursing intervention for children with tracheal intubation in the intensive care unit has a significant effect on the stress status of the throat and hemodynamic stability of the children, and the children recover quickly and the quality of life improves significantly.