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目的探讨集束化护理干预在ICU老年患者呼吸机相关性肺炎(VAP)中的应用效果。方法选择2015年8月~2016年11月我院ICU收治的老年患者79例,并按照随机数字表法分为对照组(n=39)和观察组(n=40)。对照组行常规护理,观察组在此基础上采用集束化护理。比较两组患者机械通气时间、ICU入住时间、总住院时间、VAP发生率和病死率。结果观察组患者机械通气时间[(15.5±4.6)d]、ICU入住时间[(17.4±6.3)d]和总住院时间[(23.3±7.1)d]均短于对照组[(20.1±5.8)、(22.6±6.4)、(34.6±6.9)d],观察组VAP发生率(27.5%)、病死率(15.0%)低于对照组(53.8%、48.7%),以上差异有统计学意义(P<0.05)。结论在ICU老年患者VAP疾病治疗中,集束化护理干预可以有效地缩短患者的机械通气时间、住院时间,降低VAP发生率和病死率,促进病情康复。
Objective To explore the effect of cluster nursing intervention in ventilator-associated pneumonia (VAP) in elderly patients with ICU. Methods Seventy-five elderly patients admitted to our hospital from August 2015 to November 2016 were divided into control group (n = 39) and observation group (n = 40) according to random number table. Control group routine care, the observation group on the basis of cluster nursing. The mechanical ventilation time, ICU admission time, total hospital stay, VAP incidence and mortality were compared between the two groups. Results The observation group had shorter duration of mechanical ventilation (15.5 ± 4.6 days), duration of ICU stay (17.4 ± 6.3 days), and total length of stay (23.3 ± 7.1 days) in the observation group (20.1 ± 5.8) , (22.6 ± 6.4), (34.6 ± 6.9) d respectively. The incidence of VAP in the observation group was 27.5% and the case fatality rate was 15.0% lower than that in the control group (53.8%, 48.7%). The difference was statistically significant P <0.05). Conclusions In the treatment of VAP disease in elderly patients with ICU, intensive nursing intervention can effectively shorten the duration of mechanical ventilation and hospitalization, reduce the incidence of VAP and mortality, and promote the recovery of the disease.