摘要
目的 观察中药封包联合集束化环境院感管理降低院内肺部感染风险的临床效果.方法 将150 例重症监护室(ICU)机械通气患者按照随机数字表法分为2 组,对照组75 例予常规院内环境管理,干预组75 例在对照组基础上加中药封包联合集束化环境院感管理,持续干预至患者转出ICU.比较2 组肺部感染率、28 天死亡率、机械通气时间、ICU入住时间;比较2 组临床肺部感染量表(CPIS)评分、英国胸科协会改良肺炎量表(CURB-65)评分变化;比较2 干预后高频接触物体表面消毒效果;比较2 组空气菌落数、消毒5h后菌落数;比较2 组清洁人员环境清洁认知得分.结果 干预组肺部感染率、28 天死亡率、机械通气时间、ICU入院时间均低于对照组(P<0.05).干预组CPIS评分、CURB-65 评分均低于对照组(P<0.05).干预组干预后高频接触物体表面消毒合格率高于对照组(P<0.05).干预组空气菌落数、消毒5h后菌落数均少于对照组(P<0.05).干预组清洁人员环境清洁认知得分高于对照组(P<0.05).结论 中药封包联合集束化环境院感管理,能提高环境清洁质量,降低院内肺部感染发生风险及严重程度,还可提高清洁人员的环境清洁认知水平.
Abstract
Objective To observe the effectiveness of herbal medicine sealing therapy combined with bundle infection management in reducing the risk of nosocomial pulmonary infection(NPI).Methods A total of 150 patients receiving mechani-cal ventilation admitted to intensive care unit(ICU)were randomly assigned into control group(n=75)and intervention group(n=75).All patients were managed by routine infection management schemes,and those in intervention group additionally re-ceived herbal medicine sealing therapy combined with bundle infection management.The intervention continued until the transfer out of ICU.The aim was to compare pulmonary infection rate,28-day mortality,mechanical ventilation duration,ICU hospitali-zation time,clinical pulmonary infection score(CPIS),CURB-65(confusion,uremia,respiratory rate,blood pressure,age 65 years)score,quality rate of surface disinfection of high-frequency objects,numbers of air bacteria at hours 0 and 5 of disin-fection,cognitive level of environmental cleaning in cleaning staff between groups.Results Patients in the intervention group presented significantly lower pulmonary infection rate,28-day mortality,mechanical ventilation duration,and ICU hospitaliza-tion time(P<0.05).Patients in the intervention group had significantly lower CPIS and CURB-65 scores,significantly higher quality rate of surface disinfection of high-frequency objects,significantly lower numbers of air bacteria at hours 0 and 5 of dis-infection(P<0.05).The cognitive level of environmental cleaning in cleaning staff were significantly higher than those of control group(P<0.05).Conclusion The herbal medicine sealing therapy combined with infection management bundle can improve the quality of environmental cleaning,reduce the risk and severity of NPI,and improve cognitive level of environmental cleaning in cleaning staff.
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