侧向旋转体位密闭式吸痰护理对急诊重症监护室机械通气患者呼吸机相关性肺炎的预防效果

Preventive Effect of Closed sputum Aspiration Nursing in Lateral Rotation position on Ventilator-associated Pneumonia in Patients with Mechanical Ventilation in Emergency Intensive Care Unit

目的探讨侧向旋转体位使用密闭式吸痰导管吸痰护理对急诊重症监护室机械通气患者呼吸机相关性肺炎的预防效果。方法选取2021年7月至2023年6月在本院急诊重症监护室收治的机械通气患者72例,按照随机数字表法分组,分为对照组和观察组,两组各36例,对照组患者应用常规吸痰法,观察组应用侧向旋转体位密闭式吸痰。分别于入院1d后、护理7d后统计两组患者排痰量、24h排痰次数、血气分析指标(pH、PaO_(2)、PaCO_(2))、CPIS评分,并统计护理期间VAP发生率。结果入院1d后两组排痰量、24h排痰次数比较差异均无统计学意义(P>0.05),护理7d后两组排痰量均较入院1d后上升,24h排痰次数下降,组间比较,观察组排痰量高于对照组(P<0.05),24h排痰次数低于对照组(P<0.05);观察组VAP发生率2.78%低于对照组(P<0.05),护理7d后观察组CPIS评分低于对照组(P<0.05);入院1d后两组血气分析指标比较差异均无统计学意义(P>0.05),护理7d后两组PaO_(2)均较入院1d后上升,PaCO_(2)较入院1d后下降,组间比较,观察组PaO_(2)高于对照组(P<0.05),PaCO_(2)低于对照组(P<0.05)。结论侧向旋转体位密闭式吸痰护理可以有效预防急诊重症监护室机械通气患者的呼吸机相关性肺炎,改善呼吸功能,增加排痰量,减少吸痰次数。

Objective To investigate the preventive effect of lateral rotation with closed sputum aspiration catheter on ventilator-associated pneumonia in patients with mechanical ventilation in emergency intensive care unit.Methods Seventy-two patients with mechanical ventilation admitted to the emergency intensive care unit of our hospital from July 2021 to June 2023 were selected and divided into control group and observation group according to random number table method,with 36 cases in each group.Patients in the control group received conventional sputum aspiration,while those in the observation group received closed sputum aspiration with lateral rotation position.Sputum output,number of sputum output,blood gas analysis index(pH,PaO_(2),PaCO_(2)),CPIS score,and incidence of VAP during the nursing period were calculated in the two groups 1 day after admission and 7 days after nursing,respectively.Results 1 day after admission,there was no statistical significance in sputum output and 24h sputum output between the two groups(P>0.05).After 7 days of nursing,the sputum output of the two groups increased compared with 1 day after admission,and the sputum output of the two groups decreased 24h.Compared between groups,the sputum output of the observation group was higher than that of the control group(P<0.05),and the sputum output of the observation group was lower than the control group(P<0.05).The incidence of VAP in the observation group was 2.78%lower than that in the control group(P<0.05),and the CPIS score in the observation group was lower than that in the control group after 7 days of nursing(P<0.05).There was no statistically significant difference in blood gas analysis indexes between the two groups 1 day after admission(P>0.05).After 7 days of nursing,PaO_(2) of the two groups increased compared with 1 day after admission,and PaCO_(2) decreased compared with 1 day after admission.Compared between groups,PaO_(2) of the observation group was higher than that of the control group(P<0.05),and PaCO_(2) was lower than that of the control group(P<0.05).Conclusion Closed sputum aspiration nursing with lateral rotating body position can effectively prevent ventilator-associated pneumonia in patients with mechanical ventilation in emergency intensive care unit,improve respiratory function,increase sputum output and reduce sputum aspiration times.