【摘要】：目的探討專人監(jiān)督執(zhí)行集束化管理方案預(yù)防呼吸機(jī)相關(guān)肺炎(VAP)的效果。方法選擇某院重癥監(jiān)護(hù)病房(ICU)2013年7月—2014年6月使用機(jī)械通氣的患者,其中2013年7—12月設(shè)為對(duì)照組(150例),采取集束化管理措施,無(wú)專人監(jiān)管;2014年1—6月(177例)設(shè)為專人監(jiān)督管理組,采取集束化管理措施,專人負(fù)責(zé)監(jiān)管,比較兩組患者VAP發(fā)病率、機(jī)械通氣時(shí)間和ICU停留時(shí)間。結(jié)果專人監(jiān)督管理組有創(chuàng)機(jī)械通氣患者141例,有創(chuàng)機(jī)械通氣日為1 937 d,發(fā)生VAP9例,VAP發(fā)病率為4.65‰;對(duì)照組有創(chuàng)機(jī)械通氣患者127例,有創(chuàng)機(jī)械通氣日為1 965 d,發(fā)生VAP21例,VAP發(fā)病率為10.69‰,兩組比較,差異有統(tǒng)計(jì)學(xué)意義(χ~2=5.68,P=0.042)。專人監(jiān)督管理組集束化管理方案總依從率、平均有創(chuàng)機(jī)械通氣時(shí)間以及停留ICU時(shí)間分別為94.92%、(11.11±2.57)d、(15.11±2.88)d,對(duì)照組分別為48.67%、(14.67±4.35)d、(19.33±5.81)d,兩組間比較,差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。結(jié)論專人監(jiān)督執(zhí)行集束化管理方案可以有效預(yù)防VAP的發(fā)生,應(yīng)建立符合臨床科室實(shí)際情況的集束化管理方案。
[Abstract]:Objective to investigate the effect of cluster management on the prevention of ventilator-associated pneumonia (VAP). Methods the patients with mechanical ventilation in (ICU) from July 2013 to June 2014 in an intensive care unit were selected as the control group (150 cases) from July to December 2013. From January to June 2014 (177 cases), the group was set up as the supervision and management group, which took the measures of cluster management. The incidence of VAP, the time of mechanical ventilation and the stay time of ICU were compared between the two groups. Results there were 141 patients with invasive mechanical ventilation in the supervisory management group. The incidence of VAP was 4.65 鈥，

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