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目的:应用集束化中西医护理干预体系,观察在ICU预防呼吸机相关性肺炎的应用,降低呼吸机相关性肺炎(VAP)的发生,提出预防VAP的科学依据。方法:2013年7月—2016年3月机械通气患者232例,2013年7月—2014年10月为对照组,2014年11月—2016年3月为干预组。对照组107例采用卫生部下发《呼吸机相关性肺炎的预防与控制方案》规范护理;干预组125例采用集束化中西医结合护理干预体系护理。统计两组患者住院天数情况、机械通气VAP感染率。结果:观察组较对照组住院天数缩短(t=6.53,P<0.05);机械通气VAP感染率明显下降(X~2=13.8,P<0.05)。结论:集束化中西医护理干预体系在高原地区“血瘀痰阻”型慢性阻塞性肺病护理中,发挥中医特色优势,有效降低了VAP的发生率。
OBJECTIVE: To observe the application of ICU in prevention of ventilator-associated pneumonia and to reduce the incidence of ventilator-associated pneumonia (VAP) and to propose a scientific basis for the prevention of VAP. Methods: From July 2013 to March 2016, 232 patients with mechanical ventilation were selected. The patients in the control group were from July 2013 to October 2014 and the intervention group from November 2014 to March 2016 respectively. The control group of 107 cases with the Ministry of Health issued a “ventilator-associated pneumonia prevention and control program” normative care; intervention group of 125 patients with intensive Integrative Medicine nursing intervention system. Statistics of the two groups of patients hospitalization days, mechanical ventilation VAP infection rate. Results: The days of hospitalization in the observation group were shorter than those in the control group (t = 6.53, P <0.05). The infection rate of VAP in mechanical ventilation decreased significantly (X ~ 2 = 13.8, P <0.05). CONCLUSION: The intensive TCM-WM nursing intervention system exerts the advantages of traditional Chinese medicine (TCM) in the treatment of chronic obstructive pulmonary disease in the areas of “blood stasis and phlegm obstruction”, effectively reducing the incidence of VAP.