Application effect of preventive nursing of ventilator-associated pneumonia in intensive care of neurologydepartment
呼吸机相关性肺炎预防护理在神经内科重症监护中的应用效果

摘要

目的 分析在神经内科重症监护室对患者采取呼吸机相关性肺炎（VAP）预防护理的应用效果。方 法 抽取 2020 年 6 月-2021 年 6 月期间我院神经内科重症监护室收治的患者 30 例并对其进行分组对比观察，分组 办法为随机信封法，接受常规神经内科重症监护室护理干预的 15 例患者为参照组，在此基础上接受呼吸机相关 性肺炎预防性护理的 15 例患者为观察组，对比两组患者带机时间、重症监护室住院时间、血气指标[包括动脉血 氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、氧合指数（PaO2/FiO2）]以及呼吸机相关性肺炎发生率。结 果 （1）观察组患者带机时间以及重症监护室住院时间均比参照组患者短（P＜0.05）；（2）干预前两组患者各 项血氧指标对比均无明显差异（P＞0.05）；干预后观察组患者 PaO2、PaO2/FiO2 均比参照组患者高，PaCO2 比参 照组患者低（P＜0.05）；（3）观察组患者呼吸机相关性肺炎发生率比参照组患者低（P＜0.05）。结论 在神经 内科重症监护室对患者实施呼吸机相关性肺炎预防性护理干预可显著降低患者呼吸机相关性肺炎发生风险、缩短 患者带机和重症监护室住院时间、改善患者血气指标水平，具有较高应用价值。

Abstract

Objective To analyze the effect of preventive nursing for patients with ventilator-associated pneumonia (VAP) in intensive care unit of neurology department.
Methods Thirty patients admitted to the intensive care Unit of the Department of Neurology of our hospital from June 2020 to June 2021 were selected and grouped for comparative observation. The grouping method was random envelope method. 15 patients receiving routine nursing intervention in the intensive care unit of the department of neurology were the reference group, and 15 patients receiving preventive nursing care of ventilator-associated pneumonia were the observation group. Time on the machine, length of stay in intensive care unit, blood gas indexes (including partial arterial oxygen pressure (PaO2), partial arterial carbon dioxide pressure (PaCO2), oxygenation index (PaO2/FiO2)) and incidence of ventilators associated pneumonia were compared between the two groups.
Results (1) The length of hospital stay and ICU stay in observation group were shorter than those in control group (P < 0.05); (2) Before intervention, there were no significant differences in all blood oxygen indexes between 2 groups (P > 0.05); After intervention, PaO2 and PaO2/FiO2 in observation group were higher than those in reference group, and PaCO2 was lower than those in reference group (P < 0.05). (3) The incidence of ventilator-associated pneumonia in observation group was lower than that in reference group (P < 0.05).
Conclusion  s Preventive nursing intervention for patients with ventilator-associated pneumonia in the intensive care unit of neurology department can significantly reduce the risk of patients with ventilator-associated pneumonia, shorten the hospitalization time of patients with ventilator-associated pneumonia and the intensive care unit, and improve the blood gas index level of patients, which has high application value.