【摘要】：目的探討專人監(jiān)督執(zhí)行集束化管理方案預防呼吸機相關肺炎(VAP)的效果。方法選擇某院重癥監(jiān)護病房(ICU)2013年7月—2014年6月使用機械通氣的患者,其中2013年7—12月設為對照組(150例),采取集束化管理措施,無專人監(jiān)管;2014年1—6月(177例)設為專人監(jiān)督管理組,采取集束化管理措施,專人負責監(jiān)管,比較兩組患者VAP發(fā)病率、機械通氣時間和ICU停留時間。結果專人監(jiān)督管理組有創(chuàng)機械通氣患者141例,有創(chuàng)機械通氣日為1 937 d,發(fā)生VAP9例,VAP發(fā)病率為4.65‰;對照組有創(chuàng)機械通氣患者127例,有創(chuàng)機械通氣日為1 965 d,發(fā)生VAP21例,VAP發(fā)病率為10.69‰,兩組比較,差異有統(tǒng)計學意義(χ~2=5.68,P=0.042)。專人監(jiān)督管理組集束化管理方案總依從率、平均有創(chuàng)機械通氣時間以及停留ICU時間分別為94.92%、(11.11±2.57)d、(15.11±2.88)d,對照組分別為48.67%、(14.67±4.35)d、(19.33±5.81)d,兩組間比較,差異均有統(tǒng)計學意義(均P0.05)。結論專人監(jiān)督執(zhí)行集束化管理方案可以有效預防VAP的發(fā)生,應建立符合臨床科室實際情況的集束化管理方案。
[Abstract]:Objective to investigate the effect of cluster management on the prevention of ventilator-associated pneumonia (VAP). Methods the patients with mechanical ventilation in (ICU) from July 2013 to June 2014 in an intensive care unit were selected as the control group (150 cases) from July to December 2013. From January to June 2014 (177 cases), the group was set up as the supervision and management group, which took the measures of cluster management. The incidence of VAP, the time of mechanical ventilation and the stay time of ICU were compared between the two groups. Results there were 141 patients with invasive mechanical ventilation in the supervisory management group. The incidence of VAP was 4.65 鈥，

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