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护理集束在重症肺炎护理中的作用

Effect of care bundles in the nursing of severe pneumonia.

作者信息

Li Jing, Wang Meiqin, Peng Lingling, Zhang Hongjuan, He Huiling, Zhao Yanhua

机构信息

Emergency Intensive Care Unit, The People's Hospital of Langfang City Langfang, China.

Hospital of People's Public Security University of China Beijing, China.

出版信息

Am J Transl Res. 2021 Mar 15;13(3):1757-1763. eCollection 2021.

Abstract

OBJECTIVE

To explore the effect of care bundles and analyze the influence of different angles of turning over on the sputum excretion of mechanically ventilated patients with severe pneumonia.

METHODS

120 patients with severe pneumonia in our hospital from October 2016 to October 2019 were equally randomized into four groups, each with 30, according to the date of admission. The control group was given conventional nursing and placed in a position of left 30°-half lying-right 30°; the group A was given comprehensive care bundles and placed in a position of left 30°-half lying-right 30°; the group B was given comprehensive care bundles and placed in a position of left 45°-half lying-right 45°, and the group C was given comprehensive care bundles and placed in a position of 60° left-half lying-60° right. The respiratory rates and oxygenation indexes of patients in the three groups (group A, B, C) in lateral position at 2 h and 6 h respectively before and after mechanical ventilation were compared. And we compared the nursing efficiency and satisfaction.

RESULTS

The control group showed lower nursing efficiency and satisfaction compared with the group A (P<0.05). The group B and C showed higher oxygenation index after six hours of ventilation compared with group A (P<0.05). After two hours of mechanical ventilation, the group B and C showed lower respiratory rate and higher oxygenation index compared with the group A, and the respiratory rate and oxygenation index of the group B were closest to the normal range (P<0.05).

CONCLUSION

The sputum excretion effect of mechanically ventilated patients with severe pneumonia was the best if they were placed in a position of left 45°-half lying-right 45° and given comprehensive care bundles.

摘要

目的

探讨护理集束干预的效果,并分析不同翻身角度对重症肺炎机械通气患者痰液排出的影响。

方法

选取2016年10月至2019年10月在我院治疗的120例重症肺炎患者,按入院日期将其随机分为四组,每组30例。对照组给予常规护理,采用左侧30°-半卧位-右侧30°体位;A组给予综合护理集束干预,采用左侧30°-半卧位-右侧30°体位;B组给予综合护理集束干预,采用左侧45°-半卧位-右侧45°体位;C组给予综合护理集束干预,采用左侧60°-半卧位-右侧60°体位。比较三组(A组、B组、C组)患者机械通气前后分别于侧卧位2 h和6 h时的呼吸频率及氧合指数,并比较护理效率及满意度。

结果

对照组护理效率及满意度低于A组(P<0.05)。通气6 h后,B组和C组氧合指数高于A组(P<0.05)。机械通气2 h后,B组和C组呼吸频率低于A组,氧合指数高于A组,且B组呼吸频率及氧合指数最接近正常范围(P<0.05)。

结论

重症肺炎机械通气患者采用左侧45°-半卧位-右侧45°体位并给予综合护理集束干预时痰液排出效果最佳。

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