脑血管病后遗症患者下呼吸道感染的相关因素分析与护理对策
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摘要
目的探讨脑血管病后遗症患者发生下呼吸道感染的原因及护理措施,为临床提供指导。方法选取2014年5月至2017年5月我院收治的180例脑血管病后遗症患者为研究对象,观察记录下呼吸道感染发生情况。对发生下呼吸道感染的原因进行分析,并制定针对性护理干预措施。结果单因素分析显示,影响脑血管病后遗症患者下呼吸道感染的因素为使用呼吸机、使用抗菌药物、接受气管切开以及插入胃管等。经多因素logistic回归分析可知,使用呼吸机、未使用抗菌药物、接受气管切开、插入胃管为独立危险因素。结论脑血管病后遗症患者发生下呼吸道感染的原因较多,如使用呼吸机、未使用抗菌药物、接受气管切开以及插入胃管,为减少下呼吸道感染的发生,应结合患者的实际病情采取合适的护理干预措施,如保证营养及液体供应、心理护理、呼吸道护理、口或鼻腔护理等。
Objective To investigate the causes of lower respiratory tract infection in patients with sequelae of cerebrovascular disease and explore nursing measures and thereby provide guidance for clinical practice. Methods To analyze the causes of lower respiratory tract infections and develop targeted care intervention,180 cases of patients with sequelae of cerebrovascular disease treated in our hospital from May 2014 to May 2017 were included,of which the patients' occurrence of respiratory infections were observed and recorded. Results Univariate analysis showed that factors affecting lower respiratory tract infection in patients with sequelae of cerebrovascular disease were the use of ventilators,the use of antibiotics,tracheotomy,and insertion of gastric tubes. Multivariate logistic regression analysis showed that the use of ventilator,non-use of antibiotics,tracheotomy,and insertion of gastric tube were independent risk factors. Conclusion There were many causes of lower respiratory tract infection in patients with sequelae of cerebrovascular disease,such as using ventilator,not using antibiotics,receiving tracheotomy and inserting gastric tube. In order to reduce the incidence of lower respiratory tract infection,patients' actual condition should be taken into consideration so as to implement appropriate care intervention such as ensuring nutrition and fluid supply,psychological care,respiratory care,oral or nasal care.
Objective To investigate the causes of lower respiratory tract infection in patients with sequelae of cerebrovascular disease and explore nursing measures and thereby provide guidance for clinical practice. Methods To analyze the causes of lower respiratory tract infections and develop targeted care intervention,180 cases of patients with sequelae of cerebrovascular disease treated in our hospital from May 2014 to May 2017 were included,of which the patients' occurrence of respiratory infections were observed and recorded. Results Univariate analysis showed that factors affecting lower respiratory tract infection in patients with sequelae of cerebrovascular disease were the use of ventilators,the use of antibiotics,tracheotomy,and insertion of gastric tubes. Multivariate logistic regression analysis showed that the use of ventilator,non-use of antibiotics,tracheotomy,and insertion of gastric tube were independent risk factors. Conclusion There were many causes of lower respiratory tract infection in patients with sequelae of cerebrovascular disease,such as using ventilator,not using antibiotics,receiving tracheotomy and inserting gastric tube. In order to reduce the incidence of lower respiratory tract infection,patients' actual condition should be taken into consideration so as to implement appropriate care intervention such as ensuring nutrition and fluid supply,psychological care,respiratory care,oral or nasal care.
引文
[1]黄小惠,王兰芬,胡姑长.唤醒干预对脑性昏迷患者觉醒意识的感知水平及预后的影响[J].护理实践与研究,2017,14(7):56-57.
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[3]杨佩珊,刘卫娟,邵霞,等.下呼吸道感染婴幼儿雾化吸入不规范的影响因素及对策研究[J].国际医药卫生导报,2016,22(16):2419-2421,2429.
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[8]王立文.雾化吸入高渗盐水对婴幼儿下呼吸道感染分泌物清除效果分析及护理[J].医药前沿,2016,6(29):277-278.
[9]孙静,肖金玲.早期护理干预对下呼吸道感染性疾病患者焦虑的影响[J].河北医药,2017,39(16):2548-2549,2552.
[10]甘院梅. ICU气管切开患者下呼吸道感染护理中精细化护理干预应用的价值[J].甘肃科技,2016,32(11):138-140.
[11]武珊珊,李琼.护理干预在左氧氟沙星治疗下呼吸道感染中的应用体会[J].临床研究,2016,24(12):131-132.
[12]解亚杰. ICU患者气管切开术后下呼吸道感染的原因分析及护理[J].中国医药指南,2017,15(9):281-282.
[2]曾兰.三合一心理干预对急性脑出血患者负性情绪及应对方式的影响[J].护理实践与研究,2017,14(1):42-43.
[3]杨佩珊,刘卫娟,邵霞,等.下呼吸道感染婴幼儿雾化吸入不规范的影响因素及对策研究[J].国际医药卫生导报,2016,22(16):2419-2421,2429.
[4] Mc Clure,Scott R,Koenig,et al. A randomized controlled field trial of a novel trimethoprim-sulfadiazine oral suspension for treatment of Streptococcus equi subsp zooepidemicus infection of the lower respiratory tract in horses[J]. Journal American Veterinary Medical Association,2015,246(12):1345-1353.
[5]张明娟,姚素秋,马再华,等.颅脑损伤致昏迷患者并发下呼吸道感染的危险因素分析[J].创伤外科杂志,2016,18(11):694-696.
[6]谭梅英.以“家庭”为中心护理在手足口病合并下呼吸道感染患儿应用价值[J].现代诊断与治疗,2016,27(4):779-780.
[7]谭宝玲.卒中单元护理措施在降低脑卒中患者获得性下呼吸道感染中的应用[J].护理实践与研究,2016,13(10):22-23.
[8]王立文.雾化吸入高渗盐水对婴幼儿下呼吸道感染分泌物清除效果分析及护理[J].医药前沿,2016,6(29):277-278.
[9]孙静,肖金玲.早期护理干预对下呼吸道感染性疾病患者焦虑的影响[J].河北医药,2017,39(16):2548-2549,2552.
[10]甘院梅. ICU气管切开患者下呼吸道感染护理中精细化护理干预应用的价值[J].甘肃科技,2016,32(11):138-140.
[11]武珊珊,李琼.护理干预在左氧氟沙星治疗下呼吸道感染中的应用体会[J].临床研究,2016,24(12):131-132.
[12]解亚杰. ICU患者气管切开术后下呼吸道感染的原因分析及护理[J].中国医药指南,2017,15(9):281-282.
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