细节护理在神经外科重症患者机械通气中的应用效果

Application effects of detail nursing in mechanical ventilation of severe patients in neurosurgery department

目的:探讨细节护理在神经外科重症患者机械通气中的应用效果。方法:回顾性分析2019年11月至2020年11月该院收治的74例神经外科重症患者的临床资料。依据护理方法不同将患者分为研究组和对照组各37例。对照组应用常规护理,研究组在对照组基础上应用细节护理。比较两组不良事件发生率,护理前后血气指标[动脉血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))及碱剩余]水平、生命质量综合评定问卷(GQOLI-74)评分,以及机械通气时间、住院时间。结果:研究组不良事件发生率低于对照组,机械通气时间和住院时间均短于对照组,差异有统计学意义(P<0.05);护理后,研究组PaO_(2)、碱剩余水平及躯体功能、心理功能、社会功能、物质生活状态等GQOLI-74评分均高于对照组,PaCO_(2)水平低于对照组,差异有统计学意义(P<0.05)。结论:细节护理应用于机械通气治疗的神经外科重症患者中,可有效预防肺部感染,降低不良事件发生率,缩短机械通气时间和住院时间,改善血气指标水平,提高生命质量。

Objective:To explore application effects of detail nursing in mechanical ventilation of severe patients in neurosurgery department.Methods:The clinical data of 74 severe patients in the Neurosurgery Department admitted to the hospital from November 2019 to November 2020 were retrospectively analyzed.According to different nursing methods,these patients were divided into study group and control group,37 cases in each group.The control group was given routine nursing,while the study group was given detail nursing on the basis of that of the control group.The incidence of adverse events,the blood gas index levels[arterial partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),and base excess]before and after the nursing,the general quality of life inventory(GQOLI-74)score,the mechanical ventilation time,and the hospitalization time were compared between the two groups.Results:The incidence of adverse events in the study group was lower than that in the control group;the mechanical ventilation time and the hospitalization time were shorter than the control group;and the differences were statistically significant(P<0.05).After the nursing,the PaO_(2) and base excess levels as well as the the GQOLI-74 scores of physical function,psychological function,social function and material life status in the study group were higher than those in the control group;the PaCO_(2) level was lower than that of the control group;and the differences were statistically significant(P<0.05).Conclusions:During the mechanical ventilation of the severe patients in the neurosurgery department,the detail nursing can effectively prevent the pulmonary infection,reduce the incidence of adverse events,shorten the mechanical ventilation time and the hospitalization time,improve the blood gas index levels,and improve the quality of life.