积极护理元素整合法下的集束化护理在小儿呼吸机相关性肺炎中的应用效果

Study on the Application Effect of Cluster Nursing Under the Integration of Active Nursing Elements in Children’s VAP

目的:观察积极护理元素整合法下的集束化护理在小儿呼吸机相关性肺炎(VAP)中的应用效果。方法:选择121例VAP患儿为研究对象,采用抽签法按1∶1比例将其分为观察组(61例)和对照组(60例)。对照组实施常规护理,观察组实施基于积极护理元素整合法下的集束化护理,比较2组患儿护理后的临床指标、不良预后发生情况、护理前后的简化小儿危重病例评分(PCIS)变化情况及体征改善情况。结果:护理后观察组患儿的呼吸机停用时间[(25.45±0.31)vs(27.44±0.28)d]、ICU转出时间[(26.42±0.36)vs(28.45±0.37)d]、住院时间低于对照组[(30.24±0.17)vs(32.44±0.36)d],再插管率(6.56%vs 18.33%)、病死率(1.64%vs 11.94%)低于对照组(P<0.05);护理前2组患儿的PCIS评分及体征指标差异无统计学意义(P>0.05);护理1、3、7 d后观察组PCIS评分高于对照组。结论:基于积极护理元素整合法为小儿VAP实施集束化护理可缩短其机械通气治疗时间并加快ICU转出及出院进程,对降低患儿再插管或死亡风险、改善不良预后均有积极意义。

Objective:To observe the application effect of cluster nursing under the method of active nursing element integration in children with VAP.Methods:121 children with VAP were admitted as the research object,and they were divided into the observation group(61 cases)and the control group(60 cases)at a ratio of 1∶1 by drawing lots.The control group only carried out routine nursing.The observation group carried out intensive nursing based on the integration of active nursing elements.The clinical indicators,adverse prognosis,PCIS score changes before and after nursing,and the improvement of physical signs between the two groups were compared.Results:After nursing,the time to ventilator discontinuation[(25.45±0.31)vs(27.44±0.28)d],time to ICU transfer[(26.42±0.36)vs(28.45±0.37)d],and the length of hospital stay[(30.24±0.17)vs(32.44±0.36)d],reintubation rate(6.56%vs 18.33%),and mortality rate(1.64%vs 11.94%)in the observation group were lower than those in the control group;Before nursing,there was no significant difference in PCIS scores and physical indicators between the two groups(P>0.05);after 1,3,7 days of nursing care,the PCIS score of the observation group was higher than that of the control group.Conclusion:The implementation of cluster nursing based on the integration of active nursing elements for children's VAP can shorten the time of mechanical ventilation treatment and accelerate the process of ICU transfer and discharge,which is of positive significance in reducing the risk of reintubation or death of children,improving the poor prognosis.