目的 探讨加强阻断胃肠道病原菌纵向移位的护理措施对呼吸机相关性肺炎(VAP)的预防作用.方法 采用前瞻性随机对照临床试验.收集3a间人住河北省秦皇岛市第一医院重症监护病房(ICU)并行有创机械通气的患者共133例,按入院先后顺序随机分为干预组和对照组,分别给予加强阻断胃肠道病原菌纵向移位的护理措施和常规护理措施,观察两组患者在VAP发生率和预后方面的差别.结果 (1)与常规护理组比较,干预护理组患者VAP的总发生率和晚期发生率均明显低于与常规护理组(28.79％ vs 53.73％,P=0.006 1;21.21％ vs41.79％,P=0.0180)；但在早期VAP发生率,两组患者比较差异无统计学意义(7.58％ vs 11.94％,P=0.5786).(2)与常规护理组比较,干预护理组患者在机械通气时间、入住ICU时间和死亡率等均明显低于前者,差异有统计学意义(P值分别为0.0158,0.0363,0.0478).结论 强化阻断胃肠道病原菌纵向移位的护理措施能明显降低VAP的发生率并改善预后,积极有效的护理措施是预防VAP低成本、低风险的方法.
Preventive effect of posture nursing intervention on ventilator-associated pneumonia
Objective To approach the preventive effect of blocking the dislocation of gastrointestinal tract pathogenic bacteria on ventilator- associated pneumonia (VAP). Methods This is a prospective random control clinical test. About 133 patients who receiving invasive mechanical ventilation in our intensive care unit (ICU) were enrolled in our trial. All patients were divided into two groups: intervention and control group. The intervention group received the nursing measures of blocking the dislocation of gastrointestinal tract pathogenic bacteria, and the control group received the usual nursing measures. Then observed the differences of the incidence of VAP and prognosis between the two groups. Results (1) The incidence of all VAP and late onset VAP were significantly lower in intervention group than that in control group (28. 79% vs 53. 73%, P=0. 0061; 21.21% vs 41.79%, P = 0. 0180). But there were no difference in eraly onset VAP between the two groups (7. 58% vs 11. 94% , P=0. 5786). (2)There were a less duration of mechanical ventilation, a less time of staying in ICU ward and a lower mortality rate in the intervention group than that in the control group (P = 0. 0158, P= 0. 0363, P = 0. 0478). Conclusion Taking the nursing measures of blocking the dislocation of gastrointestinal tract pathogenic bacteria may significantly reduce the incidence of VAP and improve the prognosis of patients. It is a low-cost and low-risk nursing measures in preventing VAP.
NETL
NSTL
万方数据
维普
