卢艳如+蓝如料+卢国琇+覃荣苗

【摘要】目的探讨呼吸机集束化护理方案在预防新生儿呼吸机相关性肺炎（VAP）中的应用效果。

方法采用回顾性研究方法，按集束干预实施前后将158例机械通气患儿分为对照组80例和观察组78例，对照组给予常规护理，观察组除常规护理外，制订集束化护理措施进行干预。对比观察两组VAP发生率及相关指标。

结果观察组的机械通气时间、住院时间短于对照组，住院费用少于对照组，比较差异均有统计学意义（P<0.01）。观察组的VAP发生率、二次机械通气率低于对照组，治愈好转率高于对照组，病死率低于对照组，比较差异均有统计学意义（P<0.05）。

结论呼吸机机械通气集束化护理方案预防新生儿VAP疗效显著，方案科学、合理、规范，值得推广。

【关键词】呼吸机相关性肺炎；机械通气；集束护理；新生儿

中图分类号：R473.5文献标识码：ADOI：10.3969/j.issn.10031383.2017.02.013

【Abstract】ObjectiveTo explore the application effect of ventilator cluster nursing program in the prevention of neonatal ventilatorassociated pneumonia （VAP）.

Methods Retrospective study was adopted in this study，and 158 cases of VAP were divided into observation group（78 cases） and control group（80 cases） before and after cluster intervention.The control group were given routine nursing，and based on which the observation group were intervened by cluster nursing.The incidence of VAP and related indexes were compared between the two groups.

ResultsIn the observation group，mechanical ventilation time and hospitalization time were significantly shorter，and hospitalization costs were significantly lower than those of the control group，difference was statistically significant（P<0.01）.In addition，the incidence of VAP，secondary mechanical ventilation rate and mortality of the observation group was lower than those of the control group，but curing rate was significantly higher，so difference was statistically significant（P<0.05）.

ConclusionVentilator mechanical ventilation cluster nursing program has significant effect in the prevention of neonatal VAP，it is scientific，reasonable and standardized，and thus is worth promoting.

【Key words】VAP；mechanical ventilation；cluster nursing program；neonate

新生儿呼吸机相关性肺炎（VAP）是NICU机械通气患儿最为常见的感染，发生率高达57.1%[1]，VAP增加了患儿的病残率和病死率，延长了住院时间，增加住院费用，预防VAP亦成为NICU当前感染控制的首要任务。集束化护理指当患者在难以避免的风险下进行治疗时由医护人员提供的一系列安全有效的护理干预的集合[2]。集束化护理干预在成人中已得广泛研究，取得满意效果，但在新生儿领域相关研究较少[3]。我院NICU采用集束化护理方案预防新生儿VAP，VAP的发生率明显下降，疗效显著，现报道如下。

1资料与方法

1.1一般资料

选取2014年2月～2016年3月我院NICU收治的行机械通气的78例新生儿为观察组，在常规治疗的基础上实施集束化护理方案，其中早产儿52例，足月儿26例；……