集束化护理在预防呼吸机相关性肺炎中的应用

目的:探讨机械通气集束化护理在预防呼吸机相关性肺炎的作用。方法:选择2011年1~12月机械通气患者225例作为对照组,2012年1~12月机械通气患者262例作为观察组,对照组采用常规的护理方法,观察组采用包括严格手卫生、加强口腔护理、重视气道湿化、定时监测气囊压、持续声门下吸引、每天进行拔管评估、呼吸机管路的护理、半卧位(抬高床头30°~45°)等集束化护理措施,观察两组患者VAP的发病率、入住ICU的时间、机械通气时间、ICU的医疗费用。结果:观察组患者VAP的发病率、入住ICU时间、机械通气时间、ICU的医疗费用均低于对照组(P0.05)。结论:集束化护理可降低机械通气患者VAP发病率,减少机械通气时间和医疗费用,值得临床推广应用。

Application of cluster based care in prevention of ventilator associated pneumonia

Objective： To investigate mechanical ventilation of cluster based care in the prevention of ventilator associated pneumonia. Methods： Chose 225 patients with mechanical ventilation from January to December in 2011 as the control group, chose 262 patients with mechanical ventilation from January to December in 2012 as the observation group. The control group used conventional methods of nursing, observation group adopted including strict hand hy- giene, strengthen oral nursing, attention to airway humidification, regular monitoring of air bag pressure, continuous aspiration of subglottic secretion, eve- ryday. Extubation nursing assessment, ventilator pipe, semireclining position（ elevate head of bed 30 °- 45°） and nursing measures, two groups were ob- served in patients with the incidence of VAP, ICU stay time, mechanical ventilation time, ICU medical expenses. Results： The patients in the observation group the incidence of VAP, ICU stay time, mechanical ventilation time, ICU medical costs were lower than the control group （ P 〈 0.05 ）. Conclusions ： Cluster based care is the effective measures to reduce the incidence of VAP in patients with mechanical ventilation.