目的:探讨基于集束化理念的气道分级管理在新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome，NRDS)机械通气患儿中的应用。方法:选取 2018 年 10 月—2022 年 10 月鄂州市中心医院收治的 96 例NRDS机械通气患儿作为研究对象。根据随机数表法将其分为研究组与常规组，各 48 例。常规组实施常规气道管理护理，研究组实施基于集束化理念的气道分级管理。比较两组时间指标，护理前、出院时血气分析指标，不良事件。结果:研究组机械通气时间与住院时间均短于常规组，差异有统计学意义(P<0。05)。出院时，两组动脉血氧分压(partial pressure of oxygen in arterial blood，PaO2)、氧合指数(oxygenation index，OI)水平均升高，动脉血二氧化碳分压(partial pressure of carbon dioxide in arterial blood，PaCO2)降低，研究组PaO2、OI水平均高于常规组，PaCO2 低于常规组，差异有统计学意义(P<0。05)。研究组呼吸机相关性肺炎、痰液堵塞发生率均低于常规组，差异有统计学意义(P<0。05)。结论:基于集束化理念的气道分级管理应用于NRDS机械通气患儿中，可缩短其机械通气时间与住院时间、改善血气指标、降低呼吸机相关性肺炎与痰液堵塞发生率。
Application of Airway Grading Management Based on Clustering Concept in Mechanical Ventilation Children with Neonatal Respiratory Distress Syndrome
Objective:To explore the application of airway grading management based on clustering concept in mechanical ventilation children with neonatal respiratory distress syndrome(NRDS).Method:Ninety-six children with NRDS mechanical ventilation treated in E'zhou Central Hospital from October 2018 to October 2022 were selected as the study objects.According to random number table method,the patients were divided into study group and routine group,48 cases in each group.The routine group implemented routine airway management nursing,and the study group implemented airway grading management based on clustering concept.The time indexes,the blood gas analysis indexes before nursing and at discharge,and the adverse event of the two groups were compared.Result:The mechanical ventilation time and hospital stay in the study group were shorter than those in the routine group,and the differences were statistically significant(P<0.05).At discharge,the levels of partial pressure of oxygen in arterial blood(PaO2)and oxygenation index(OI)were increased in both groups,the partial pressure of carbon dioxide in arterial blood(PaCO2)was reduced,the PaO2 and OI levels in the study group were higher than those in the routine group,and the PaCO2 levels were lower than those in the routine group,the differences were statistically significant(P<0.05).The incidences of ventilator-associated pneumonia and sputum blockage in the study group was lower than those in the routine group,and the differences were statistically significant(P<0.05).Conclusion:The application of airway grading management based on clustering concept in NRDS mechanical ventilation children can shorten the time of mechanical ventilation and hospital stay,improve blood gas index,and reduce the incidences of ventilator-associated pneumonia and sputum blockage.
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