基于人工气道气囊压力监测的综合性护理对呼吸机相关性肺炎发生率的影响

Effect of comprehensive nursing based on artificial airway balloon pressure monitoring on the incidence of ventilator-associated pneumonia

目的探讨基于人工气道气囊压力监测的综合性护理对呼吸机相关性肺炎(VAP)发生率的影响。方法选取遵义医科大学第五附属(珠海)医院收治的98例ICU行机械通气的患者为研究对象,按不同护理方法分为观察组和对照组,每组49例。对照组给予常规护理,观察组给予人工气道气囊压力监测下的综合性护理。比较两组患者机械通气时间、ICU住院时间及住院总时间;比较两组患者VAP发生率;比较两组患者病死率;比较两组患者护理满意度。结果观察组的机械通气时间、ICU住院时间及住院总时间均明显少于对照组(P<0.05);观察组总体VAP发生率明显低于对照组(P<0.05);两组患者的总体死亡率、发生VAP后死亡率及VAP归因死亡率差异无统计学意义(P>0.05);观察组护理满意率(93.88%)明显高于对照组(77.55%),且研究组调查问卷得分(80.23±3.48)分远高于对照组(77.25±6.33)分,差异具有统计学意义(P<0.05)。结论对ICU患者采取基于人工气道气囊压力监测的综合性护理,可有效减少VAP的发生率,缩短患者的通气时间及住院时间,同时还能提高患者的满意度。

Objective To explore the effect of comprehensive nursing based on artificial airway balloon pressure monitoring on the incidence of ventilator-associated pneumonia(VAP).Methods A total of 98 ICU patients with mechanical ventilation admitted to the Fifth Affiliated Hospital of Zunyi Medical University(Zhuhai)were selected as the research objects.According to different nursing methods,they were divided into observation group and control group,49 cases in each group.The control group was given routine nursing,while the observation group was given comprehensive nursing under artificial airway balloon pressure monitoring.Mechanical ventilation time,length of ICU stay and total length of stay were compared between the two groups.The incidence of VAP was compared between the two groups.The mortality of the two groups was compared.Nursing satisfaction was compared between the two groups.Results The duration of mechanical ventilation,length of stay in ICU and total length of stay in the observation group were significantly shorter than those in the control group(P<0.05).The incidence of VAP in the observation group was significantly lower than that in the control group(P<0.05).There were no significant differences in overall mortality,post-VAP mortality and VAP attributable mortality between the two groups(P>0.05).The nursing satisfaction rate of the observation group(93.88%)was significantly higher than that of the control group(77.55%),and the questionnaire score of the research group〔(80.23±3.48)points〕was much higher than that of the control group〔(77.25±6.33)points〕,with statistical significance(P<0.05).Conclusions Comprehensive nursing based on artificial airway balloon pressure monitoring for ICU patients can effectively reduce the incidence of VAP,shorten the ventilation time and hospital stay of patients,and improve patients'satisfaction.