一种新的鼻腔护理方法在机械通气患者中的应用。

A new nasal cavity nursing methods application in patients with mechanical ventilation.

出版信息

Pak J Med Sci. 2013 Jul;29(4):977-81. doi: 10.12669/pjms.294.3636.

DOI:10.12669/pjms.294.3636

PMID:24353671

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3817784/

Abstract

OBJECTIVE

To compare different nasal cavity nursing methods on mechanically ventilated patients.

METHODS

According to acute physiology and chronic health evaluation (APACHEII), 615 cases of mechanically ventilated patients were divided into group A, group B and group C by stratified random method. Traditional oral nursing plus aspirating secretions from oral cavity and nasal cavity q6h were done in group A. Based on methods in group A, normal saline was used for cleaning nasal cavity in group B. Besides the methods in group A, atomizing nasal cleansing a6h was also used in group C. Incidence rate of Ventilator-Associated Pneumonia (VAP) and APACHE II scores after administrating were compared. The correlation between APACHE II score and outcomes was analyzed by Spearman-rank correlation.

RESULTS

In group A, incidence of VAP was 36.76%, group B was 30.24%, group C was 20.38%, and the difference was statistically significant. APACHE II scores in group C were significantly lower compared with group A and B. APACHE II score was negatively correlated with clinical outcomes.

CONCLUSIONS

For mechanically ventilated patients, nasal nursing can't be ignored and the new atomizing nasal cleaning is an effective method for VAP prevention.

摘要

目的

比较不同鼻腔护理方法对机械通气患者的影响。

方法

根据急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ），将 615 例机械通气患者采用分层随机方法分为 A、B、C 3 组，A 组采用传统口腔护理+口腔、鼻腔每 6 小时吸引分泌物，B 组在 A 组基础上采用生理盐水鼻腔冲洗，C 组在 A 组基础上每 6 小时采用雾化鼻腔清洁，比较 3 组患者呼吸机相关性肺炎（VAP）发生率和护理后 APACHEⅡ评分。采用 Spearman 秩相关分析 APACHEⅡ评分与结局的相关性。