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呼吸机管道更换时间对 COPD 患者呼吸机相关性肺炎的影响

Effect of ventilator tube replacement time on COPD patients with ventilator-associ-ated pneumonia

摘要目的:探讨呼吸机管道更换时间与COPD患者呼吸机相关性肺炎( VAP )的相关性,总结呼吸机管道更换维护方法,抑制肺炎并发。方法选取2011年4月至2013年2月我院呼吸内科收治的COPD住院患者共90例,随机分为对照组1、对照组2、实验组各30例,管道更换频率分别为1 d/次、2 d/次、4 d/次,统计并发VAP例次与时间、死亡例次和病原菌检验结果。结果对照组1并发VAP 1次、2次、3次率与死亡率分别为63.33%、30.00%、6.67%和16.67%,对照组2为60.00%、33.33%和13.33%、13.33%,实验组为60.00%和13.33%、0.00%、13.33%,实验组与对照组1和对照组2并发1次VAP、死亡率差异不显著(P>0.05),但多次并发VAP例数少于对照组1、对照组2,差异显著(P <0.05);G-杆菌是VAP感染主要菌种,G+球菌其次,不同例次VAP病原菌菌种差异不显著( P>0.05);对照组1并发第1次VAP时间短于对照组2、实验组,实验组并发第2次VAP时间长于对照组1、对照组2,对照组2并发第3次VAP时间长于对照组1,差异显著( P<0.05)。结论呼吸机管道更换越频繁,并发多次VAP的概率越高,但并不影响并发1次VAP概率与死亡率,对照组1并发VAP的时间相对更短,因此出于抑制多次并发考虑,可适当延长初次更换时间,并发VAP后可延长气道更换时间。

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abstractsObjective To investigate the correlation of ventilator tube replacement time with COPD patients with ventilator-associ-ated pneumonia ( VAP) , summarize ventilator tube replacement maintenance methods, inhibit pneumonia.Methods April 2011-February 2013 admitted to hospital Respiratory Medicine 90 COPD patients were randomly divided into control 1 group, control 2 group, and experi-mental group, 30 patients in each group, pipe replacement frequencies were 1 d/times, 2 d/times, 4 d/times, time and concurrent VAP ca-ses, cases of death, pathogen test results were compared.Results In control 1 group, a concurrent VAP once, twice, three times and mor-tality rates were 63.33%, 30.00%, 6.67% and 16.67% respectivley, in control 2 group, were 60.00%, 33.33%, 13.33% and 13.33%respectivley, in the experimental group were 60.00%, 13.00%, 0.00% and 13.33% respectively.There were no significant differences in once concurrent VAP and mortality rate between the experimental group and control 1, 2 groups.Cases with more times con-current VAP in experimental group were significantly less than those of control 1 and 2 groups (P<0.05).G-bacilli VAP infection was the major species, G+cocci was the second species.There was no significant difference in kind of pathogenic bacteria among different cases of VAP ( P>0.05) .The first time of complicated with VAP in control 1 group was shorter than that of control 2 group and experimental group, the second time of complicated with VAP in experimental group was longer than that of control 1, 2 groups, the third time of of complicated with VAP in control 2 group was longer than that of control 1 group (P<0.05) .Conclusion More frequently the replacement of the venti-lator tube, the higher the probability of VAP multiple concurrent, but which does not affect the probability of concurrent 1 time VAP and mortality.Time of complicated with VAP in the control 1 group is relatively shorter, so for multiple concurrent inhibition consider, first re-placement time may be extended, the airway may be extended after concurrent VAP replacement time.

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作者 刘敏 [1] 学术成果认领
作者单位 绵阳市江油第二人民医院, 四川绵阳,621701 [1]
分类号 R473.5
栏目名称 护理研究
DOI 10.3760/cma.j.issn.1673-4351.2015.08.001
发布时间 2015-05-07
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国际护理学杂志

国际护理学杂志

2015年8期

1009-1011页

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