集束化护理预防急诊患者呼吸道感染的临床效果分析

目的探讨预防急诊患者呼吸道感染的集束化护理方案及其临床应用效果。方法纳入2013年6月-2014年6月急诊及急诊ICU患者132例,按入院时间先后分为对照组64例和干预组68例,制定集束化护理干预方案。干预组在基础护理基础上给予集束化护理,对照组采用常规急危重症护理。对比两组急诊或急诊ICU患者住院期间呼吸道感染发生率、气管切开率、机械通气时间、呼吸机相关性肺炎发生率及其他并发症等。结果干预组呼吸道感染总发生率、上呼吸道感染发生率、下呼吸道感染发生率均显著低于对照组（P〈0.05）。干预组机械通气患者气管切开率、VAP发生率均显著低于对照组（P〈0.05）,机械通气时间显著少于对照组（P〈0.05）。干预组误吸、肺不张、痰痂阻塞发生率显著低于对照组（P〈0.05）。结论集束化护理干预集合多种有效预防各类急诊患者呼吸道感染的护理方式,有序实施可减少自主呼吸及机械通气患者呼吸道感染及其他并发症发生率,减少机械通气时间和气管切口率。

Clinical effectiveness analysis of emergency care and prevention cluster of respiratory tract infections in patients

Objective To investigate the prevention of respiratory tract infections in patients with cluster of emergency nursing program and the clinical application. Methods Selected 132 cases of patients in emergency and emergency ICU from June 2013 to June 2014, according to the admission time they were divided into control group （64 cases） and inter- vention group （68 cases）, the development of cluster-based nursing interventions in primary care based on conventional care was given to the intervention group while the control group recieved conventional emergency critical care, the in- cidence of respiratory tract infections, tracheotomy rate, duration of mechanical ventilation, ventilator-associated pneu- monia incidence and other complications were compared between two groups. Results The overall incidence of respira- tory infections, the incidence of upper respiratory tract infection, lower respiratory incidence rate of intervention group were significantly lower than those of the control group （P〈0.05）. The mechanical ventilation in patients with tracheoto- my rate, VAP incidence rate of intervention group were significantly lower than those of the control group （P〈0.05）, du- ration of mechanical ventilation of intervention group was significantly less than the control group （P〈0.05）. The rate of aspiration, atelectasis, sputum blocking incidence of intervention group were significantly lower than the control group （P〈0.05）. Conclusion The collection of a variety of cluster nursing interventions is effective in preventing respiratory tract infections in patients with various types of emergency care approach, can reduce the orderly implementation of spontaneous breathing and mechanical ventilation in patients with respiratory tract infections and other complications rate, reduce duration of mechanical ventilation and tracheal incision rates.