综合性护理干预在重症加强护理病房机械通气患者中的应用(1)
[摘要]目的 探讨综合性护理干预在重症加强护理病房机械通气患者中的应用。方法 选取2018年10月～2019年8月我院收治的88例重症加强护理病房(ICU)机械通气患者，根据随机数字表法分为对照组(n=44)和观察组(n=44)。对照组接受常规护理干预，观察组接受综合性护理干预。比较两组的呼吸机相关性肺炎发生率、炎症指标以及不良反应总发生率。结果 观察组呼吸机相关性肺炎总发生率低于对照组，差异有统计学意义(P<0.05);观察组降钙素原、白细胞计数、C反应蛋白低于对照组，差异均有统计学意义(P<0.05);观察组不良反应总发生率低于对照组，差异有统计学意义(P<0.05)。结论 对ICU机械通气患者实施综合性护理干预，能显著降低呼吸机相关性肺炎发生率，改善炎症因子水平，降低不良反应发生风险，效果显著。
[关键词]重症加强护理病房;呼吸机相关性肺炎;综合性护理;炎症指标;不良反应
[中图分类号] R472 [文献标识码] A [文章编号] 1674-4721(2020)7(a)-0243-04
Application of comprehensive nursing intervention in patients with mechanical ventilation in intensive care unit
CHENG Ying
Department of Critical Medicine， the Fourth Affiliated Hospital of Nanchang University， Jiangxi Province， Nanchang 330000， China
[Abstract] Objective To explore the application of comprehensive nursing intervention in patients with mechanical ventilation in intensive care unit. Methods From October 2018 to August 2019， 88 patients with mechanical ventilation in our hospital intensive care unit (ICU) were selected. According to the random number table method， the patients were divided into control group (n=44) and observation group (n=44). The control group received routine nursing intervention， while the observation group received comprehensive nursing intervention. The incidence of ventilator-associated pneumonia， inflammatory indexes and total incidence of adverse reactions were compared between the two groups. Results The total incidence of ventilator-associated pneumonia in the observation group was lower than that in the control group， with statistical difference (P<0.05). The levels of procalcitonin， leukocyte count and C-reactive protein in the observation group were lower than those in the control group， with statistical differences (P<0.05). The total incidence of adverse reactions in the observation group was lower than that in the control group， with statistical difference (P<0.05). Conclusion Comprehensive nursing intervention for patients with mechanical ventilation in ICU can significantly reduce the incidence of ventilator-associated pneumonia， improve the level of inflammatory factors， and reduce the risk of adverse reactions.
[Key words] Intensive care unit; Ventilator-associated pneumonia; Comprehensive nursing; Inflammatory index; Adverse reactions
重症加强病房(intensive care unit，ICU)是对危重症患者治疗场所，ICU患者病情较危重，且病情变化快，在对其治疗时多需机械通气治疗，以维持患者呼吸功能，提升疾病治疗效果[1-2]。在对ICU患者实施机械通气时，存在多种影响因素使患者出现呼吸机相关性肺炎症状，使患者病情加重，加大临床治疗难度及治疗成本，提高疾病死亡率，在对患者实施机械通氣时需对其辅以合理护理干预措施，以预防ICU呼吸机相关性肺炎疾病产生[3]。在临床护理方面，集束化护理、循证医学理论、体位指导等护理干预方式在预防ICU呼吸机相关性肺炎疾病取得理想的效果[4-6]。Micik等[7]认为，对ICU患者护理应从5个方面入手，即限制使用机械通气、防止误吸入分泌物、预防呼吸道感染、规避用污染的呼吸设备及早期活动，这与本研究开展综合护理措施及目标是一致的。本研究以我院收治的88例ICU机械通气患者为研究对象，探讨综合性护理干预对预防ICU呼吸机相关性肺炎效果及预后效果，现报道如下。, 百拇医药(程英)
[关键词]重症加强护理病房;呼吸机相关性肺炎;综合性护理;炎症指标;不良反应
[中图分类号] R472 [文献标识码] A [文章编号] 1674-4721(2020)7(a)-0243-04
Application of comprehensive nursing intervention in patients with mechanical ventilation in intensive care unit
CHENG Ying
Department of Critical Medicine， the Fourth Affiliated Hospital of Nanchang University， Jiangxi Province， Nanchang 330000， China
[Abstract] Objective To explore the application of comprehensive nursing intervention in patients with mechanical ventilation in intensive care unit. Methods From October 2018 to August 2019， 88 patients with mechanical ventilation in our hospital intensive care unit (ICU) were selected. According to the random number table method， the patients were divided into control group (n=44) and observation group (n=44). The control group received routine nursing intervention， while the observation group received comprehensive nursing intervention. The incidence of ventilator-associated pneumonia， inflammatory indexes and total incidence of adverse reactions were compared between the two groups. Results The total incidence of ventilator-associated pneumonia in the observation group was lower than that in the control group， with statistical difference (P<0.05). The levels of procalcitonin， leukocyte count and C-reactive protein in the observation group were lower than those in the control group， with statistical differences (P<0.05). The total incidence of adverse reactions in the observation group was lower than that in the control group， with statistical difference (P<0.05). Conclusion Comprehensive nursing intervention for patients with mechanical ventilation in ICU can significantly reduce the incidence of ventilator-associated pneumonia， improve the level of inflammatory factors， and reduce the risk of adverse reactions.
[Key words] Intensive care unit; Ventilator-associated pneumonia; Comprehensive nursing; Inflammatory index; Adverse reactions
重症加强病房(intensive care unit，ICU)是对危重症患者治疗场所，ICU患者病情较危重，且病情变化快，在对其治疗时多需机械通气治疗，以维持患者呼吸功能，提升疾病治疗效果[1-2]。在对ICU患者实施机械通气时，存在多种影响因素使患者出现呼吸机相关性肺炎症状，使患者病情加重，加大临床治疗难度及治疗成本，提高疾病死亡率，在对患者实施机械通氣时需对其辅以合理护理干预措施，以预防ICU呼吸机相关性肺炎疾病产生[3]。在临床护理方面，集束化护理、循证医学理论、体位指导等护理干预方式在预防ICU呼吸机相关性肺炎疾病取得理想的效果[4-6]。Micik等[7]认为，对ICU患者护理应从5个方面入手，即限制使用机械通气、防止误吸入分泌物、预防呼吸道感染、规避用污染的呼吸设备及早期活动，这与本研究开展综合护理措施及目标是一致的。本研究以我院收治的88例ICU机械通气患者为研究对象，探讨综合性护理干预对预防ICU呼吸机相关性肺炎效果及预后效果，现报道如下。, 百拇医药(程英)