CAJ | 학술논문

目的探讨循证护理应用在重型颅脑损伤机械通气患者中解决呼吸机相关性肺炎(ventilatorssoeiated pneumonia,VAP)的实施效果.方法以重型颅脑损伤机械通气患者100例作为研究对象,随机分为观察组和对照组各50例.观察组重点从“呼吸机管道护理、气道护理、口咽部和声门下护理、气囊套管护理、阻止气管导管上生物膜(ETT-BF)形成脱落、肠内营养护理、卧位护理、病室环境和医务人员的手消毒”等几个方面进行循证,获取最佳证据,实施循证护理;对照组实施常规护理.比较2组患者在相同时间段的VAP发生情况、脱机时间及死亡率.结果 2组患者VAP的发生时间和发生率、脱机时间、死亡率等均存在差异,观察组疗效显著优于对照组.结论实施循证护理能明显缩短重型颅脑损伤机械通气患者脱机时间,使VAP的发生率和死亡率明显降低,改善预后,节约成本.
목적 탐토순증호리응용재중형로뇌손상궤계통기환자중해결호흡궤상관성폐염(ventilatorssoeiated pneumonia,VAP)적실시효과.방법 이중형로뇌손상궤계통기환자100례작위연구대상,수궤분위관찰조화대조조각50례.관찰조중점종“호흡궤관도호리、기도호리、구인부화성문하호리、기낭투관호리、조지기관도관상생물막(ETT-BF)형성탈락、장내영양호리、와위호리、병실배경화의무인원적수소독”등궤개방면진행순증,획취최가증거,실시순증호리;대조조실시상규호리.비교2조환자재상동시간단적VAP발생정황、탈궤시간급사망솔.결과 2조환자VAP적발생시간화발생솔、탈궤시간、사망솔등균존재차이,관찰조료효현저우우대조조.결론 실시순증호리능명현축단중형로뇌손상궤계통기환자탈궤시간,사VAP적발생솔화사망솔명현강저,개선예후,절약성본.
Objective To evaluate the application effect of evidence-based nursing in reducing ventilator-associated pneumonia (VAP) of patients with severe head injury. Methods 100 patients with severe head injury using mechanical ventilation were randomly divided into the control group and the observation group with 50 patients in each group.The observation group explored evidence from nursing of ventilator tube,oropharyngeal and sound sects care,airway care,balloon sleeves care to prevent biofilm on the endotracheal tube(ETT-BF) to fall off,enteral nutrition care,decubitus care,ward environment and the hand disinfection of medical staff and was given evidence- based nursing.The control group took routine care.The incidence of VAP,off-line time and mortality rate of the two groups were compared during the same time period. Results The incidence of VAP,off-line time,mortality rate showed significant difference between the two groups.The observation group showed better effect. Conclusions Implementation of evidence-based nursing can significantly reduce the off-line time of patients with severe traumatic brain injury using mechanical ventilation.It can decrease the incidence of VAP and mortality rate,improve the prognosis and reduce medical cost.