脓毒症患者的集束化护理及效果观察

目的 探讨对脓毒症患者实施集束化护理的临床效果.方法 选取该院ICU 20 l2年1月~2015年12月收治的患者120例,分为实验组62例和对照组58例.对照组实行应用传统护理方法;实验组在传统护理方法的基础上实行集束化护理,如早期液体复苏目标检测、早期床旁CRRT及其监测护理、胸部物理治疗护理及开展院感目标性监测预防感染等.对比两组患者集束化护理前后的CVP、MAP、乳酸、尿量、液体平衡、APARCHⅡ评分、SCr、机械通气时间、ICU治疗时间、院内感染发生率及28 d生存率.结果 实验组液体复苏达标时间缩短、血流动力学稳定、肾功能恢复显著、机械通气时间、ICU治疗时间缩短、院内感染发生率下降、28 d生存率提升(P<0.05).结论 集束化护理是一种较好的护理方式,减少了护理并发症,改善患者的预后,值得在危重症护理领域推广.

Clustered nursing and effect observation of sepsis patients

Objective To explore the clinical effect of bundle care in patients with sepsis. Methods A total of 120 patients in ICU of our hospital from January 2012 to December 2015 were selected and divided into experimental group with 62 cases and control group with 58 cases. The control group was given the conventional nursing, the experimental group was given bundle nursing on the basis of conventional nursing, such as the detection of initial fluid resuscitation,the monitoring and care of initial bedside CRRT, hysical therapy of chest and carrying out the target monitoring of nosocomial infection, etc. The CVP, MAP, Lac, urine volume, fluid balance, APARCHⅡ score, SCr, mechanical ventilation time, ICU treatment time, incidence rate of hospital infection and 28 days survival rate of the two groups before and after nursing were compared. Results In the experimental group, the standard time of fluid resuscitation was shortened, hemodynamics was stable, renal function significantly recovered, mechanical ventilation time and ICU treatment time were shortened, incidence rate of hospital infection decreased, 28 days survival rate increased (P <0. 05) . Conclusions Clustered nursing is a good nursing mode, which can reduce nursing complications and improve patients' prognosis, is worth popularizing for the nursing of critical disease.