集束化預防策略在預防新生兒呼吸機相關性肺炎的研究

林福忠 嚴爭 王健 危夷

[摘要] 目的 探討集束化預防策略在預防新生兒呼吸機相關性肺炎的作用。方法 便利選擇2017年6月—2019年5月行機械通氣的新生兒120例，采用數字法分為對照組和觀察組各60例。對照組接受常規護理，觀察組在常規護理的基礎之上接受集束化預防策略護理。比較兩組患兒護理后的兩組患兒護理后機械通氣時間、NICU住院時間比較、呼吸機相關性肺炎發生率。 結果 治療后觀察組患兒的機械通氣時間為﹙92.64±15.23﹚h，NICU住院時間為﹙12.06±2.35﹚d均低于對照組患兒的機械通氣時間﹙102.37±23.67﹚h、NICU住院時間﹙14.28±2.17﹚d（t=8.371、6.548，P<0.05）。觀察組患兒呼吸機相關性肺炎發生2例、發生率3.33%，低于對照組患兒呼吸機相關性肺炎發生9例、發生率15.00%（t=5.031，P<0.05）。 結論 集束化預防策略在預防新生兒呼吸機相關性肺炎的治療中能夠減少患兒機械通氣時間和住院時間，有效降低了新生兒呼吸機相關性肺炎的發生率。

[關鍵詞] 集束化預防;新生兒;呼吸機相關性肺炎

[中圖分類號] R5? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2020）01（b）-0076-03

Study on Prevention of Neonatal Ventilator-associated Pneumonia by Clustering Prevention Strategy

LIN Fu-zhong， YAN Zheng， WANG Jian， WEI Yi

Department of Pediatrics， Fuzhou First Hospital， Fuzhou， Fujian Province， 350009 China

[Abstract] Objective To investigate the role of clustering prevention strategy in preventing neonatal ventilator-associated pneumonia. Methods A total of 120 neonates who underwent mechanical ventilation convenient from June 2017 to May 2019 were enrolled in the control group and the observation group. The control group received routine care and the observation group received clustering prevention strategy care based on routine care. The postoperative nursing time， NICU hospitalization time， and ventilator-associated pneumonia were compared between the two groups. Results After treatment， the mechanical ventilation time of the observation group was ﹙92.64±15.23﹚h， and the NICU hospitalization time was ﹙12.06±2.35﹚d， which was lower than the mechanical ventilation time of the control group ﹙102.37±23.67﹚h， and the NICU hospitalization time was ﹙14.28±2.17﹚d（t=8.371， 6.548， P<0.05）. There were 2 cases of ventilator-associated pneumonia in the observation group， the incidence rate was 3.33%， 9 cases were lower than the control group， and the incidence rate was 15.00% （t=5.031， P<0.05）. Conclusion The clustering prevention strategy can reduce the mechanical ventilation time and hospitalization time in the treatment of neonatal ventilator-associated pneumonia， and effectively reduce the incidence of neonatal ventilator-associated pneumonia.

[Key words] Clustering prevention; Newborn; Ventilator-associated pneumonia

呼吸機相關性肺炎是指患者在使用機械通氣的48 h后或者拔管的48 h內出現的肺炎，是機械通氣中嚴重的并發癥之一，致死率高達51.36%[1]。醫源性因素是引發新生兒呼吸機相關性肺炎的重要致病因素，所以預防護理能夠起到良好的預防效果。因此，該文2017年6月—2019年5月收治的行機械通氣的新生兒120例作為研究對象，探討集束化預防策略在預防新生兒呼吸機相關性肺炎的作用。報道如下。