目标策略的针对性护理对重症肺部感染患者血气指标及住院时间的影响

目的 探讨目标策略的针对性护理对重症肺部感染患者血气指标及住院时间的影响。方法 选取2021年5月至2022年9月重症肺部感染患者152例，依据简单随机数字表法分为研究组（n=76）与对照组（n=76）。对照组采取常规护理，研究组在对照组基础上采取目标策略的针对性护理。统计两组干预前后呼吸情况[呼吸频率（RR）、血氧饱和度（SaO2）、动脉血二氧化碳分压（PaCO2）、动脉血氧分压（PaO2）]、肺部感染评分（CPIS）及呼吸机相关肺炎（VAP）发生率、住院时长（机械通气时长、ICU入住时长、住院总时长）、炎症因子水平[C反应蛋白（CRP）、降钙素原（PCT）、白细胞介素-6（IL-6）]水平、并发症发生率。结果 干预后，两组患者RR、PaCO2较干预前降低，SaO2、PaO2较干预前增高（P＜005），且研究组RR、PaCO2低于对照组，SaO2、PaO2高于对照组（P＜0.05）；两组CPIS分值较干预前降低（P＜0.05），且研究组CPIS分值低于对照组，VAP发生率（2.63%）低于对照组（11.84%）（P＜0.05）；研究组机械通气时长、ICU入住时长、住院总时长短于对照组（P＜0.05）；两组CRP、PCT、IL-6水平较干预前降低（P＜0.05），且研究组CRP、PCT、IL-6水平低于对照组（P＜0.05）；研究组并发症发生率（2.63%）低于对照组（11.84%）（P＜0.05）。结论 采取目标策略的针对性护理对重症肺部感染患者实施干预，可调节血气状态，改善呼吸状况及肺部感染控制情况，并能下调炎症因子表达，降低VAP及并发症发生率，利于缩短患者康复时长。

Effects of targeted nursing strategies on blood gas indexes and length of stay in patients with severe pulmonary infection

ObjectiveTo explore the effect of targeted nursing with goal oriented strategies on blood gas indexes and length of hospital stay in patients with severe pulmonary infection. Methods A total of 152 patients with severe pulmonary infection from May 2021 to September 2022 were selected and randomly divided into a study group(n=76)and a control group(n=76)according to simple random number table method. The control group received routine care，while the study group took targeted nursing with goal-oriented strategy based on the routine care. Respiratory parameters (respiratory rate[RR]，oxygen saturation[SaO2]，arterial partial pressure of carbon dioxide[PaCO2]，arterial partial pressure of oxygen[PaO2])，pulmonary infection score(CPIS)，incidence of VAP， length of stay(duration of mechanical ventilation， length of ICU stay，total length of stay)，and levels of inflammatory factors(C The levels of reactive protein[CRP])， procalcitonin[PCT]， interleukin-6[IL-6])，and the incidence of complications were recorded and compared between the two groups. Results After intervention， RR and PaCO2 decreased while SaO2 and PaO2 increased in both groups (P＜0.05),with the study group showing lower RR and PaCO2,and higher SaO2 and PaO2 than the control group(P＜0.05). The CPIS scores decreased in both after intervention(P＜0.05)，with the study group having lower CPIS score and lower VAP occurrence rate (2.63%) compared to the control group(11.84%)(P＜0.05).The study group had shorter duration of mechanical ventilation duration，length of ICU stay and total hospital stay (P＜0.05).The levels of CRP，PCT and IL-6 decreased in both groups after intervention (P＜0.05)，with the study group having lower levels of CRP，PCT and IL-6 than the control group(P＜0.05).The complication rate of the study group(2.63%)was lower than that of the control group(11.84%)(P＜0.05). Conclusions Targeted nursing with goal-oriented strategy in patients with severe pulmonary infection can regulate blood gas status，improve respiratory status and pulmonary infection control， down-regulate inflammatory factor expression，reduce the incidence of VAP and complications， and help shorten the recovery time of patients.