集束化护理干预在机械通气行CRRT 患者中的应用效果

摘要

Objective To analyze the application effect of bundle care in mechanical ventilation patients with continuous renal re‐placement therapy(CRRT) .Methods A total of 96 patients with severe craniocerebral injury ,receiving mechanical ventilation and CRRT treatment in Intensive Care Unit (ICU ) ,were enrolled and divided into bundle nursing group and routine nursing group . Nursing effect were evaluated and compared .Results One week after treatment ,serum creatinine ,blood urea nitrogen ,Acute Phys‐iology and Chronic Health EvaluationⅡ score were significantly decreased(P<0 .05) .Of bundle nursing group ,mechanical ventila‐tion time and ICU treatment time were significantly shorter than control group ,incidence rates of puncture point infection ,blocking pipe ,unplanned extubation ,catheter related bloodstream infection ,ventilator associated pneumonia and 28 d mortality were signifi‐cantly lower than control group ,basic nursing qualified rate and patients satisfaction were significantly higher than control group ( P<0 .05) .Conclusion CRRT treatment could be helpful to alleviate pathogenetic condition of patients receiving mechanical venti‐lation .Bundle care could help to shorten mechanical ventilation time and ICU treatment time ,reduce complications ,then improve care quality .%目的：分析集束化护理干预在机械通气行连续性肾脏替代治疗（CRRT ）患者中的应用效果。方法选取重症医学科（ICU ）收治的重型颅脑损伤机械通气患者96例，所有患者均给予CRRT治疗，根据入院时间分为集束化护理组和对照组，各48例。对护理效果进行评价和比较。结果治疗1周后，所有患者血肌酐、尿素氮、急性生理及慢性健康状况评分系统Ⅱ评分均明显降低（P＜0．05）。集束化护理组机械通气时间、ICU治疗时间明显短于对照组，穿刺点感染发生率、堵管发生率、非计划拔管发生率、导管相关性感染发生率、呼吸机相关性肺炎发生率、28 d病死率均明显低于对照组，基础护理合格率、患者满意度均明显高于对照组（P＜0．05）。结论机械通气患者行CRRT治疗能缓解病情，集束化护理有助于缩短机械通气时间和ICU治疗时间，降低并发症发生率，提高护理质量。