风险预警制度指导的预见性护理在ICU急性呼吸衰竭患者中的应用效果(1)
[摘要] 目的 探討风险预警制度指导的预见性护理对ICU急性呼吸衰竭患者呼吸机相关性肺炎(VAP)发生情况、机械通气时间的影响。 方法 依据护理干预方案的不同将2017年1月～2019年1月青海省第四人民医院接收的98例ICU急性呼吸衰竭患者分为对照组(49例)与研究组(49例)，对照组施以常规护理干预，研究组在对照组基础上施以风险预警制度指导的预见性护理。观察VAP发生情况与呼吸机撤机情况，记录机械通气时间、ICU入住时间、住院时间，测定血乳酸水平、急性生理与慢性健康评分(APACHEⅡ)。 结果 研究组VAP发生率、呼吸机依赖率、再插管率均明显低于对照组(P < 0.05)，一次性撤机成功率明显高于对照组(P < 0.05);研究组机械通气时间、ICU入住时间、住院时间明显低于对照组(P < 0.05);干预后两组血乳酸水平、APACHEⅡ评分低于干预前(P < 0.05)，且干预后研究组血乳酸水平、APACHEⅡ评分低于对照组(P < 0.05)。 结论 开展风险预警制度指导的预见性护理，可减少ICU急性呼吸衰竭患者VAP发生情况，降低呼吸机依赖，改善预后，效果可靠。
[关键词] 风险预警制度;预见性护理;ICU急性呼吸衰竭;呼吸机相关性肺炎;机械通气时间
[中图分类号] R473.5 [文献标识码] A [文章编号] 1673-7210(2019)11(b)-0152-04
Application effect of predictive nursing guided by risk early warning system in patients with acute respiratory failure in ICU
WEI Xia CAO Xiuting
Department of Critical Care Medicine， the 4th People′s Hospital of Qinghai Province， Qinghai Province， Xining 810000， China
[Abstract] Objective To explore the effect of predictive nursing guided by risk warning system on the occurrence of ventilator associated pneumonia (VAP) and mechanical ventilation time in patients with acute respiratory failure in ICU. Methods Ninety-eight patients with acute respiratory failure in ICU received in the 4th People′s Hospital of Qinghai Province from January 2017 to January 2019 were divided into control group (49 cases) and study group (49 cases) according to the different nursing intervention schemes. The control group was given routine nursing intervention， while the study group was given predictive nursing under the guidance of risk early warning system on the basis of the control group. The occurrence of VAP and ventilator weaning were observed， the duration of mechanical ventilation， ICU stay and hospital stay were recorded， the blood lactate level， acute physiology and chronic health score (APACHE Ⅱ) were measured. Results The incidence of VAP， ventilator dependence rate and re-intubation rate in the study group were significantly lower than those in the control group (P < 0.05)， and the success rate of one-time withdrawal success rate was significantly higher than that in the control group (P < 0.05). The duration of mechanical ventilation， ICU stay and hospital stay in the study group were significantly lower than those in the control group (P < 0.05). After intervention， the blood lactate level and APACHE Ⅱ score in the two groups were lower than those before intervention (P < 0.05)， and the blood lactate level and APACHE Ⅱ score in the study group were lower than those in the control group (P < 0.05). Conclusion Predictive nursing guided by risk early warning system can reduce the incidence of VAP in patients with acute respiratory failure in ICU， reduce ventilator dependence， improve prognosis， and have reliable results., 百拇医药(魏霞 曹秀廷)
[关键词] 风险预警制度;预见性护理;ICU急性呼吸衰竭;呼吸机相关性肺炎;机械通气时间
[中图分类号] R473.5 [文献标识码] A [文章编号] 1673-7210(2019)11(b)-0152-04
Application effect of predictive nursing guided by risk early warning system in patients with acute respiratory failure in ICU
WEI Xia CAO Xiuting
Department of Critical Care Medicine， the 4th People′s Hospital of Qinghai Province， Qinghai Province， Xining 810000， China
[Abstract] Objective To explore the effect of predictive nursing guided by risk warning system on the occurrence of ventilator associated pneumonia (VAP) and mechanical ventilation time in patients with acute respiratory failure in ICU. Methods Ninety-eight patients with acute respiratory failure in ICU received in the 4th People′s Hospital of Qinghai Province from January 2017 to January 2019 were divided into control group (49 cases) and study group (49 cases) according to the different nursing intervention schemes. The control group was given routine nursing intervention， while the study group was given predictive nursing under the guidance of risk early warning system on the basis of the control group. The occurrence of VAP and ventilator weaning were observed， the duration of mechanical ventilation， ICU stay and hospital stay were recorded， the blood lactate level， acute physiology and chronic health score (APACHE Ⅱ) were measured. Results The incidence of VAP， ventilator dependence rate and re-intubation rate in the study group were significantly lower than those in the control group (P < 0.05)， and the success rate of one-time withdrawal success rate was significantly higher than that in the control group (P < 0.05). The duration of mechanical ventilation， ICU stay and hospital stay in the study group were significantly lower than those in the control group (P < 0.05). After intervention， the blood lactate level and APACHE Ⅱ score in the two groups were lower than those before intervention (P < 0.05)， and the blood lactate level and APACHE Ⅱ score in the study group were lower than those in the control group (P < 0.05). Conclusion Predictive nursing guided by risk early warning system can reduce the incidence of VAP in patients with acute respiratory failure in ICU， reduce ventilator dependence， improve prognosis， and have reliable results., 百拇医药(魏霞 曹秀廷)