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一项随机对照研究:ICU 护理风险管理联合集束化护理模式对急性呼吸窘迫综合征并呼吸机相关性肺炎患者生活质量及炎症因子水平的影响

A randomised controlled study: efficacy of ICU nursing risk management combined with the cluster nursing model and its effect on quality of life and inflammatory factor levels of patients with acute respiratory distress syndrome and ventilator-associated pneumonia.

机构信息

ICU, Wuhan Jinyintan Hospital, Wuhan, China.

Department of Surgical, Wuhan Jinyintan Hospital, Wuhan, China.

出版信息

Ann Palliat Med. 2021 Jul;10(7):7587-7595. doi: 10.21037/apm-21-1192.

Abstract

BACKGROUND

The purpose was to investigate the effect on quality of life and inflammatory factor levels of patients with acute respiratory distress syndrome (ARDS) and ventilator-associated pneumonia (VAP).

METHODS

A total of 110 ARDS patients with VAP were randomly divided into an experimental group and control group. The control group received routine nursing while the experimental group received ICU nursing risk management combined with the cluster nursing model to compare the clinical efficacy in the two groups of patients.

RESULTS

There were no significant differences in general information (P>0.05). The total clinical effective rate of patients in the experimental group was significantly higher than that of the control group (P<0.05). The Acute Physiology and Chronic Health Evaluation (APACHE II) scores of all patients after nursing were significantly lower than those before nursing (P<0.001), and the APACHE II score in the experimental group after nursing was significantly lower than that in the control group (P<0.001). The interleukin-8 (IL-8), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels of all patients after nursing were significantly lower than those before nursing (P<0.001), and the levels in the experimental group after nursing were significantly lower than those in the control group (P<0.001). The vital capacity (VC), total lung capacity (TLC), and forced expiratory volume 1 second (FEV1)/forced vital capacity (FVC) levels of all patients after nursing were significantly higher than those before nursing (P<0.001), and the levels in the experimental group after nursing were significantly higher than those in the control group (P<0.001). The MOS 36-item short form health survey (SF-36) scores of all patients after nursing were significantly higher than those before nursing (P<0.001), and the scores in the experimental group after nursing was higher than that in the control group (P<0.001).

CONCLUSIONS

ICU nursing risk management combined with the cluster nursing model can effectively and significantly reduce inflammatory reactions, improve pulmonary function, and enhance the quality of life of ARDS patients with VAP, making it worthy of promotion and application.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2100048112.

摘要

背景

目的是研究急性呼吸窘迫综合征(ARDS)和呼吸机相关性肺炎(VAP)患者生活质量和炎症因子水平的影响。

方法

将 110 例 VAP 合并 ARDS 患者随机分为实验组和对照组。对照组采用常规护理,实验组采用 ICU 护理风险管理联合集群护理模式,比较两组患者的临床疗效。

结果

两组患者一般资料比较差异无统计学意义(P>0.05)。实验组患者总有效率明显高于对照组(P<0.05)。护理后所有患者急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分均明显低于护理前(P<0.001),实验组护理后 APACHEⅡ评分明显低于对照组(P<0.001)。护理后所有患者白细胞介素-8(IL-8)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均明显低于护理前(P<0.001),实验组护理后水平明显低于对照组(P<0.001)。护理后所有患者肺活量(VC)、肺总量(TLC)、用力呼气量 1 秒率(FEV1/FVC)均明显高于护理前(P<0.001),实验组护理后水平明显高于对照组(P<0.001)。护理后所有患者 MOS 36 项简明健康调查量表(SF-36)评分均明显高于护理前(P<0.001),实验组护理后评分高于对照组(P<0.001)。

结论

ICU 护理风险管理联合集群护理模式能有效显著减轻炎症反应,改善肺功能,提高 VAP 合并 ARDS 患者生活质量,值得推广应用。

试验注册

中国临床试验注册中心,ChiCTR2100048112。

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