牛长秋

【摘 要】目的：探讨精细化护理在重症肺炎合并呼吸衰竭患者中的应用效果及对患者治疗效果和肺功能的影响。方法：收集60例重症肺炎合并呼吸衰竭患者的临床资料，按照随机分组法将患者分为观察组和对照组，各30例。两组均给予对症综合治疗，治疗期间对照组实施常规护理，观察组接受精细化护理，比较两组机械通气时间、住院时间、治疗前后肺功能指标水平和呼吸机相关性肺炎（VAP）发生率。结果：与对照组相比，观察组机械通气时间和住院时间均显著较短，VAP发生率显著较低，差异有统计学意义（P<0.05）；两组干预前PEF、PEEPi水平比较无显著差异（P>0.05）；干预后，与对照组相比，观察组PEF较高，PEEPi较低（P<0.05）。结论：给予重症肺炎合并呼吸衰竭患者精细化护理能够有效缩短患者机械通气时间，改善肺功能，减少VAP发生，促进患者康复。

【关键词】重症肺炎；呼吸衰竭；精细化护理

Analysis of the Effect of Refined Nursing Intervention on the Treatment Effect of Severe Pneumonia Complicated with Respiratory Failure and Lung Function

NIU Changqiu

The Third Hospital of Qinhuangdao City， Qinhuangdao， Hebei 066000， China

【Abstract】Objective： To explore the application effect of refined nursing in patients with severe pneumonia complicated with respiratory failure and its influence on the treatment effect and lung function of the patients.Methods： The clinical data of 60 patients with severe pneumonia combined with respiratory failure were collected， and the patients were divided into observation group and control group according to the random grouping method， with 30 cases in each group. Both groups were given symptomatic comprehensive treatment. During the treatment period， the control group received routine nursing care， and the observation group received refined nursing care. The two groups were compared mechanical ventilation time， hospital stay， lung function index levels before and after treatment， and the incidence of ventilatorassociated pneumonia （VAP）. Results： Compared with the control group， the mechanical ventilation time and hospital stay were significantly shorter in the observation group， the incidence of VAP was significantly lower， and the difference was statistically significant （P<0.05）； There was no significant difference in the levels of PEF and PEEPi between the two groups before intervention （P>0.05）； After intervention，compared with the control group， the observation group had higher PEF and lower PEEPi （P<0.05）. Conclusion： Giving refined care to patients with severe pneumonia combined with respiratory failure can effectively shorten the patient’s mechanical ventilation time， improve lung function， reduce the occurrence of VAP， and promote patient recovery.

【Key？Words】Severe pneumonia； Respiratory failure； Refined care

重症肺炎合并呼吸衰竭是临床常见的危重症，临床多给予肺泡灌洗、机械通气等對症综合治疗，治疗期间配合科学的护理干预对减少并发症有重要意义[1]。本研究对重症肺炎合并呼吸衰竭患者实施精细化护理，收效较好，报道如下。

1.1 一般资料

收集我院2020年2月至2021年5月收治的60例重症肺炎合并呼吸衰竭患者作为研究对象。将患者随机分为观察组和对照组，各30例。对照组，男17例，女13例，年龄37岁～78岁，平均年龄（60.13±7.25）岁；观察组，男16例，女14例，年龄38岁～77岁，平均年龄（60.02±7.46）岁。两组患者一般资料比较，无显著差异（P>0.05）。

1.2 方法

两组入院后给予常规对症支持治疗，包括病原学治疗、扩张气道、祛痰止咳、纠正水电解质紊乱和酸碱失衡，给予必要的营养支持、无创呼吸机或气管插管辅助通气，必要时气管切开。……