综合干预措施对昏迷患者呼吸机相关性肺炎发生率的影响

发布时间：2018-05-24 13:37

  本文选题：肺炎 + 呼吸机相关性　； 参考：《中华医院感染学杂志》2016年20期

【摘要】：目的探讨昏迷患者呼吸机相关性肺炎(VAP)有效干预措施,以降低VAP的发生率、促进患者康复。方法选取2014年12月-2015年11月建立人工气道机械通气昏迷患者83例,按随机数字表法分为观察组41例、对照组42例,两组均落实预防呼吸机相关性肺炎常规护理措施;观察组在此基础上采用封闭式吸痰,并根据肺部情况给予纤维支气管镜肺部灌洗,遵医嘱行腹部超声药物透入治疗促进肠蠕动;观察两组返流误吸、VAP发生情况,带呼吸机、住ICU时间。结果观察组返流误吸、VAP发生率分别为2.44%、4.88%显著低于对照组,观察组机械通气、住ICU时间(8.86±3.54、10.57±3.46)d明显低于对照组差异均有统计学意义(P0.05)。结论建立人工气道行机械通气的昏迷患者,采用综合干预措施能有效减少返流导致的误吸,降低VAP发生率,缩短机械通气及住ICU时间,此方法值得临床推广应用。
[Abstract]:Objective to investigate the effective intervention measures of ventilator associated pneumonia (VAP) in coma patients in order to reduce the incidence of VAP and promote the recovery of the patients. Methods from December 2014 to November 2015, 83 patients with mechanical ventilation coma were divided into observation group (n = 41) and control group (n = 42). Routine nursing measures to prevent ventilator-associated pneumonia were carried out in both groups. On this basis, the observation group was treated with closed suction and bronchofiberscope lavage according to the lung condition, the abdominal ultrasound drug penetration therapy was performed to promote intestinal peristalsis, and the occurrence of VAP was observed in the two groups. Stay in ICU time. Results the incidences of VAP in the observation group were 2.44% and 4.88%, respectively, and the duration of ICU in the observation group was significantly lower than that in the control group (8.86 卤3.54 卤10.57 卤3.46 days), which was significantly lower than that in the control group (P 0.05). Conclusion Comprehensive intervention measures can effectively reduce the incidence of VAP and mechanical ventilation and the duration of ICU in coma patients with mechanical ventilation. This method is worth popularizing in clinical practice.
【作者单位】： 四川省医学科学院四川省人民医院城东ICU;
【基金】：2011年四川省卫生厅科研项目(30305030178110163)
【分类号】：R563.1
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本文编号：1929248