护理干预对老年重症肺炎并发呼吸机相关性肺炎患者临床效果观察

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英文篇名：Clinical Observation of Nursing Intervention on Elderly Patients with Severe Pneumonia Complicated with Ventilator-associated Pneumonia 作者：张小桐 英文作者：ZHANG Xiao-tong;Department of Critical Care Medicine,Beijing Chinese Medicine Hospital,Capital Medical University; 关键词：老年重症肺炎 ; 呼吸机相关性肺炎 ; PEEPi ; PEF ; SAS评分 ; SDS评分 英文关键词：Severe pneumonia in elderly patients;;Ventilator-associated pneumonia;;PEEPi;;PEF;;SAS score;;SDS score 中文刊名：YXXX 英文刊名：Medical Information 机构：首都医科大学附属北京中医医院重症医学科; 出版日期：2019-04-15 出版单位：医学信息 年：2019 期：v.32;No.487 语种：中文; 页：YXXX201908059 页数：3 CN：08 ISSN：61-1278/R 分类号：190-192

摘要

目的结合临床实践经验,探讨老年重症肺炎并发呼吸机相关性肺炎患者护理观察及并发症。方法选取我院2015年6月～2018年6月收治的老年重症肺炎并发呼吸机相关性肺炎患者92例,随机分为观察组和对照组,每组46例。对照组给予常规性综合护理,观察组给予加强护理干预。比较两组患者的住院时间、机械通气时间、并发症发生情况、治疗前后PEEPi、PEF水平,以及焦虑情况、生活质量评分。结果观察组患者的住院时间、机械通气时间分别为(14.57±3.60)d、(10.16±2.54)d,均短于对照组的(19.65±4.03)d、(14.32±3.81)d,并发症发生率低于对照组(6.52%vs 28.26%),差异具有统计学意义(P<0.05)。治疗后,观察组患者PEEPi水平低于对照组,PEF水平高于对照组,差异有统计学意义(P<0.05)。干预后1周和出院后1个月,观察组患者SAS、SDS评分均优于对照组,差异有统计学意义(P<0.05)。观察组患者在生理机能、生理职能、身体疼痛、总体健康、活力、社会职能、情感职能、精神健康等方面评分均优于对照组,差异有统计学意义(P<0.05)。结论对老年重症肺炎并发呼吸机相关性肺炎患者进行加强护理干预,可改善患者的肺功能,降低发生机械通气相关性肺炎的风险,减少并发症发生,缩短住院时间,减轻患者焦虑状态,提高患者生活质量。
        Objective To explore the nursing observation and complications of elderly patients with severe pneumonia complicated with ventilator-associated pneumonia in combination with clinical practice. Methods A total of 92 patients with severe pneumonia complicated with ventilator-associated pneumonia admitted to our hospital from June 2015 to June 2018 were randomly divided into observation group and control group, with 46 cases in each group. The control group received routine comprehensive care and the observation group received intensive care intervention. The hospitalization time, mechanical ventilation time, complications, PEEPi, PEF levels before and after treatment, as well as anxiety and quality of life scores were compared between the two groups. Results The hospitalization time and mechanical ventilation time of the observation group were(14.57±3.60)d and(10.16±2.54)d, respectively, which were shorter than the control group(19.65 ±4.03)d,(14.32±3.81)d, and complications occurred.The rate was lower than the control group(6.52% vs 28.26%),the difference was statistically significant( P<0.05). After treatment, the PEEPi level of the observation group was lower than that of the control group, and the PEF level was higher than that of the control group, the difference was statistically significant(P<0.05). One week after the intervention and one month after the discharge, the SAS and SDS scores of the observation group were better than the control group, the difference was statistically significant(P<0.05). The scores of the observation group were better than those of the control group in terms of physiological function, physiological function, body pain, overall health, vitality, social function, emotional function and mental health,the difference was statistically significant(P <0.05). Conclusion Intensive nursing intervention for elderly patients with severe pneumonia complicated with ventilator-associated pneumonia can improve the lung function of the patients, reduce the risk of mechanical ventilationassociated pneumonia, reduce the occurrence of complications, and shorten the length of stay in hospital. Reduce the anxiety state of the patients,improve the quality of life of the patients.

引文

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