同质化服务在新生儿重症监护室机械通气中的应用

Application of uniform care in the mechanical ventilation of neonatal intensive care unit

目的:研究同质化服务对机械通气患儿并发症的影响。方法:选取医院新生儿重症监护室实施机械通气的182例呼吸机相关性肺炎(VAP)患儿,按随机数表法将其分为对照组(82例)和观察组(100例)。对照组行常规护理,观察组给予同质化护理。分析两组患儿机械通气相关并发症VAP的发生率、因人机对抗使用镇静药频次(≥5次)、气管插管非计划性拔管(UEX)的发生率及抗生素使用时间(≥30 d)。结果:观察组VAP、因人机对抗使用镇静药频次(≥5次)、气管插管UEX及抗生素使用时间(≥30 d)均低于对照组,其差异有统计学意义(x^2=5.407,x^2=16.993,x^2=6.025,x^2=5.835;P<0.05)。结论:同质化服务可以保证同种疾病患儿在不同地区及医院享受到同质护理,减少机械通气的相关并发症。

Objective: To study the influence of uniform care on the complications of children who underwent mechanical ventilation. Methods: A total of 182 children with ventilator-associated pneumonia(VAP) who once underwent mechanical ventilation in neonatal intensive care unit(NICU) were enrolled in this research. And all of them were randomly divided into control group(n=82) and observation group(n=100). The control group received routine care and the observation group received uniform care. The incidence of VAP that was relative with mechanical ventilation, the frequency of using depressant because of man-machine counteraction(≥5 times), the incidence of unregulated extubation(UEX) of trachea cannula and the used time of antibiotic(≥30 days) between the two groups were compared. Results: The incidence of VAP, the frequency of using depressant because of man-machine counteraction(≥5 times), the incidence of UEX of trachea cannula and the used time of antibiotic(≥30 days) of observation group were significantly lower than those of control group(x2=5.407, x2=16.993, x2=6.025, x2=5.835, P<0.05). Conclusion: Uniform care can ensure children with same disease in different areas can receive same care, and reduce the relative complications of mechanical ventilation.