發(fā)布時間：2018-05-24 13:37

  本文選題：肺炎 + 呼吸機(jī)相關(guān)性　； 參考：《中華醫(yī)院感染學(xué)雜志》2016年20期

【摘要】：目的探討昏迷患者呼吸機(jī)相關(guān)性肺炎(VAP)有效干預(yù)措施,以降低VAP的發(fā)生率、促進(jìn)患者康復(fù)。方法選取2014年12月-2015年11月建立人工氣道機(jī)械通氣昏迷患者83例,按隨機(jī)數(shù)字表法分為觀察組41例、對照組42例,兩組均落實(shí)預(yù)防呼吸機(jī)相關(guān)性肺炎常規(guī)護(hù)理措施;觀察組在此基礎(chǔ)上采用封閉式吸痰,并根據(jù)肺部情況給予纖維支氣管鏡肺部灌洗,遵醫(yī)囑行腹部超聲藥物透入治療促進(jìn)腸蠕動;觀察兩組返流誤吸、VAP發(fā)生情況,帶呼吸機(jī)、住ICU時間。結(jié)果觀察組返流誤吸、VAP發(fā)生率分別為2.44%、4.88%顯著低于對照組,觀察組機(jī)械通氣、住ICU時間(8.86±3.54、10.57±3.46)d明顯低于對照組差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論建立人工氣道行機(jī)械通氣的昏迷患者,采用綜合干預(yù)措施能有效減少返流導(dǎo)致的誤吸,降低VAP發(fā)生率,縮短機(jī)械通氣及住ICU時間,此方法值得臨床推廣應(yīng)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 鹵3.54 鹵10.57 鹵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.
【作者單位】： 四川省醫(yī)學(xué)科學(xué)院四川省人民醫(yī)院城東ICU;
【基金】：2011年四川省衛(wèi)生廳科研項(xiàng)目(30305030178110163)
【分類號】：R563.1
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本文編號：1929248