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目的探讨呼吸机集束化干预策略中口腔护理联合体位护理对预防呼吸机相关性肺炎(VAP)的效果。方法选取2015年3月至2016年3月收治的符合纳入标准的经气管插管机械通气的患者155例作为研究对象,对其临床资料进行回顾性分析研究,155例分为对照组45例、口腔护理组41例、体位护理组37例、联合护理组32例,比较四组患者VAP发生率、机械通气时间、住院时间。结果四组患者年龄、性别、急性生理与慢性健康评分(APACHEⅡ)比较差异均未见统计学意义(P均>0.05);联合护理组VAP发生率(21.88%)均显著低于对照组(51.11%)、口腔护理组(31.71%)及体位护理组(32.43%),差异均有统计学意义(P均<0.05);联合护理组机械通气时间(10.34±1.19)d和住院时间(20.12±1.88)d均低于对照组[(18.53±1.68)d,(30.33±2.57)d]、口腔护理组[(13.21±2.03)d,(24.75±3.14)d]及体位护理组[(14.17±1.25)d,(26.18±2.36)d]。结论口腔护理联合体位护理能有效降低VAP的发生率,这对气管插管机械通气患者的护理有一定的指导意义。
Objective To investigate the effect of combined oral care and postural nursing on the prevention of ventilator-associated pneumonia (VAP) in the cluster strategy of ventilator. Methods A total of 155 patients with endotracheal intubation mechanical ventilation admitted from March 2015 to March 2016 were enrolled in this study. The clinical data were retrospectively analyzed. 155 cases were divided into control group (45 cases) 41 oral care group, 37 nursing group and 32 nursing group. The incidence of VAP, duration of mechanical ventilation and hospital stay were compared between the four groups. Results There was no significant difference in age, sex, acute physiology and chronic health score (APACHEⅡ) between the four groups (all P> 0.05). The incidence of VAP in the combined nursing group (21.88%) was significantly lower than that in the control group %), Oral care group (31.71%) and body care group (32.43%), the differences were statistically significant (all P <0.05); the time of mechanical ventilation and the duration of hospital stay in combined nursing group were (10.34 ± 1.19) and 1.88) d were significantly lower than those in the control group [(18.53 ± 1.68) d, (30.33 ± 2.57) d], oral care group [(13.21 ± 2.03) d, (24.75 ± 3.14) d] 1.25) d, (26.18 ± 2.36) d]. Conclusion Oral nursing combined with body care can effectively reduce the incidence of VAP, which has some guiding significance for the nursing of tracheal intubation mechanical ventilation patients.