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目的探讨集束化护理预防重症医学科(ICU)患者呼吸机相关性肺炎(VAP)发生的效果。方法回顾性选取2014年1-12月在吉林省吉林中西医结合医院ICU治疗且符合机械通气指征的181例患者资料作为观察组,同时随机抽取2012-2013年ICU收治的行机械通气治疗的172例患者作为对照组。对照组患者给予ICU常规护理,观察组患者在对照组基础上实施集束化护理,比较两组患者的VAP发生率、撤机成功率、气管切开率、病死率、机械通气时间、住院时间及住院费。结果观察组患的VAP发生率、气管切开率及病死率均明显低于对照组,而撤机成功率明显高于对照组,差异均有统计学意义(均P<0.05);观察组患者的机械通气时间、ICU住院时间均明显短于对照组,住院费用明显低于对照组,差异均有统计学意义(均P<0.05)。结论集束化护理可有效降低ICU机械通气患者VAP的发生率,促进其早日康复,可作为ICU机械通气患者的首选护理方案。
Objective To investigate the effect of cluster nursing on ventilator-associated pneumonia (VAP) in patients with intensive care unit (ICU). Methods The data of 181 patients who were treated by ICU in Jilin Hospital of Integrated Traditional Chinese and Western Medicine from January to December 2014 in Jilin Province and met the mechanical ventilation indications were retrospectively selected as the observation group. At the same time, randomly selected patients underwent mechanical ventilation during 2012-2013 in the ICU 172 patients as a control group. Patients in the control group were given regular ICU care. Patients in the observation group received intensive care based on the control group. VAP incidence, success rate of weaning, tracheotomy rate, mortality, duration of mechanical ventilation, hospital stay and Hospital expenses. Results The incidence of VAP, tracheotomy and mortality in the observation group were significantly lower than those in the control group, and the success rate of weaning was significantly higher than that in the control group (all P <0.05). In the observation group Of the mechanical ventilation time, ICU hospitalization were significantly shorter than the control group, hospitalization costs were significantly lower than the control group, the difference was statistically significant (P <0.05). Conclusions Cluster nursing can effectively reduce the incidence of VAP in ICU patients with mechanical ventilation and promote their early recovery, which may be the first choice of nursing care for ICU patients with mechanical ventilation.