基于循证理念的分级干预在ICU气管切开通气患者中的应用

Application of Evidence-based Graded Intervention in ICU Patients Undergoing Tracheotomy Ventilation

目的探讨基于循证理念的分级干预对重症监护室(ICU)气管切开通气患者中的干预效果。方法前瞻性纳入2020年1月至2022年8月郑州大学第一附属医院ICU接受气管切开通气的82例患者为研究对象,采用随机数字表法分为干预组与对照组,各41例。对照组患者接受常规护理方案,干预组患者在对照组基础上接受基于循证理念的分级干预,两组患者均护理14 d。观察对比两组护理前、护理14 d血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]变化情况,并对比两组患者ICU治疗时间、脱离呼吸机时间及总住院时间,同时观察护理期间两组患者并发症发生率。结果护理14 d,两组PaO_(2)均升高,且干预组高于对照组(P<0.05);两组PaCO_(2)均降低,且干预组低于对照组(P<0.05);干预组ICU治疗时间、脱离呼吸机时间及总住院时间均短于对照组(P<0.05);护理期间,干预组并发症发生率低于对照组(P<0.05)。结论应用基于循证理念的分级干预可有效改善ICU气管切开患者动脉血气,缩短ICU治疗时间、脱离呼吸机时间及总住院时间,且能够降低并发症发生率。

Objective To explore the intervention effect of evidence-based graded intervention on patients undergoing tracheotomy ventilation in intensive care unit(ICU).Methods A prospective study was conducted on 82 patients who received tracheotomy ventilation in the ICU of the First Affiliated Hospital of Zhengzhou University from January 2020 to August 2022.They were divided into an intervention group and a control group using random number table method,with 41 patients in each group.The control group patients received routine nursing plans,while the intervention group patients received graded interventions based on evidence-based concepts on the basis of the control group.Both groups of patients received 14 days of nursing care.The changes of blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))]before nursing and 14 days after nursing were observed and compared between the two groups.The ICU treatment time,time of leaving ventilator and total hospitalization time were compared between the two groups.The incidence of complications in the two groups during nursing was observed.Results After 14 days of nursing care,both groups showed an increase in PaO_(2),and the intervention group was higher than the control group(P<0.05).Both groups showed a decrease in PaCO_(2),and the intervention group was lower than the control group(P<0.05).The intervention group had shorter ICU treatment time,ventilator-free time,and total hospital stay compared to the control group(P<0.05).During the nursing period,the incidence of complications in the intervention group was lower than that in the control group(P<0.05).Conclusion Graded intervention based on evidence-based concept for ICU tracheotomy patients can effectively improve arterial blood gas,shorten ICU treatment time,time out of ventilator and total hospital stay,and reduce the incidence of complications.