重症肺炎机械通气患者谵妄与衰弱循证护理路径研究

Study on Evidence-based Nursing Path of Delirium and Frailty in Mechanical Ventilation Patients with Severe Pneumonia

目的:分析重症肺炎机械通气患者谵妄与衰弱循证护理路径研究。方法:选取2019年1月—2020年1月周口市中医院重症监护室收治的140例重症肺炎行机械通气治疗的患者作为研究对象,采用随机数表法将其分为对照组和实验组,每组各70例。对照组采用常规护理措施,实验组采用循证护理路径对患者实施护理内容,对比两组患者谵妄、衰弱发生率、睡眠质量评分、认知功能评分。结果:两组患者护理后睡眠量表各维度评分及总分均高于护理前,且实验组睡眠量表各维度评分及总分均优于对照组,差异有统计学意义(t=6.157、9.325、17.571、13.230、5.267、13.645、7.016,P<0.05);护理后,实验组谵妄、衰弱发生率低于对照组,差异有统计学意义(χ^(2)=8.70,P<0.05);两组患者护理后蒙特利尔认知评估量表(Mo-CA)评分高于护理前,实验组Mo-CA评分高于实验组,差异有统计学意义(t=-6.874、-14.171、12.342,P<0.05)。结论:对重症肺炎行机械通气治疗患者应用循证护理路径措施,可提高患者睡眠质量,降低谵妄、衰弱的发生率,使患者及家属满意度提高。

Objective:To analyze the evidence-based nursing path study of delirium and frailty in patients with severe pneumonia on mechanical ventilation.Methods:140 cases of severe pneumonia line mechanical ventilation patients admitted to the hospital from January 2019 to January 2020 were selected as the research subjects.They were decided into the control group and the experimental group according to radom number table method,with 70 cases in each group.The control group adopted routine nursing measures,and the experimental group adopted evidence-based nursing path to implement nursing contents.Delirium,frailty incidence,sleep quality score and nursing comfort ratings of two groups were compared.Results:The scores and total scores of RCSQ in all dimensions of the two groups after nursing were higher than those before nursing,and the scores and total scores of RCSQ in all dimensions of the experimental group were better than those in the control group,with statistically significant difference(t=6.157,9.325,17.571,13.230,5.267,13.645,7.016;P<0.05).The delirium and frailty incidence of the control group were lower than those of the experimental group(χ^(2)=8.70,P<0.05).The Mo-CA score of the two groups after nursing was higher than that before nursing,and the Mo-CA score of the experimental group was higher than that of the experimental group,with statistically significant difference(t=-6.874,-14.171,12.342;P<0.05).Conclusion:For patients with severe pneumonia treated by mechanical ventilation,using evidence-based nursing path measures can improve patients’sleep,reduce the incidence of delirium and frailty,increase the comfort of nursing for patients,and make patients and their families more satisfied.