预防RICU机械通气患者呼吸机相关性肺炎的集束化护理干预

摘要

目的 探讨集束化护理干预措施预防RICU机械通气患者呼吸机相关性肺炎的效果.方法 选取RICU病房80例机械通气患者作为研究对象,根据随机数表法分为对照组、研究组各40例.对照组采用常规护理干预,研究组采用集束化护理干预.观察并比较2组患者护理后VAP发生率、住院时间、机械通气时间及护理前后生活质量情况.结果 护理后,研究组VAP发生率为7.5％ (3/40),低于对照组的32.5％ (13/40) (P ＜0.05);研究组患者住院时间、机械通气时间均少于对照组(P＜0.05);护理后,2组患者生活质量SF-36评分均高于护理前(P＜0.05),且研究组高于对照组(P＜0.05).结论 集束化护理干预能有效抑制口腔牙菌斑分泌及黏膜细菌滋生,控制口腔内细菌数量,避免滞留物中病原菌进入患者呼吸道,提高抵抗力,保持患者乐观心态,改善心理状态,降低VAP病发率,提高生活质量,值得临床推广.%Objective To study the application of cluster nursing intervention in the prevention of ventilator-associated pneumonia in RICU patients with mechanical ventilation.Methods A total of 80 patients with mechanical ventilation in RICU of our hospital were divided into control group and study group according to random number table method,with 40 cases in each group.The control group was treated with routine nursing intervention,and the study group was given cluster nursing intervention.The incidence of VAP,hospitalization time,mechanical ventilation time and quality of life before and after nursing were observed and compared between the two groups.Results After nursing,the incidence of VAP in the study group was 7.5％ (3/40),which was lower than 32.5％ (13/40) in the control group (P ＜ 0.05).The time of hospitalization and the time of mechanical ventilation were lower in the study group than that in the control group (P ＜ 0.05).The SF-36 scores after nursing in the two groups were higher than nursing before,and the study group was higher than the control group (P ＜ 0.05).Conclusion Cluster nursing intervention can effectively inhibit the secretion of oral plaque and mucosal bacterial growth,control the number of bacteria to avoid its access to the respiratory tract,improve immunity,maintain patients'optimistic attitude,improve mental state,reduce the incidence of VAP,and improve the quality of life of patients,so it is worthy of clinical promotion.