摘要
目的探讨集束化诊治策略在预防肿瘤重症患者医院获得性肺炎中的作用。方法采用病例对照研究，对265例对照组患者采用常规预防措施，对292例观察组采用集束化干预策略，包括控制抗生素应用、手卫生、口腔护理、多重耐药菌的隔离、持续床头抬高、呼吸道管理、恰当的镇痛镇静等。比较实施前后两组患者医院获得性肺炎的发病率、归因病死率、机械通气时间、ICU停留时间、医院获得性肺炎抗生素应用频度、多重耐药病原菌感染阳性率。结果观察组患者的医院获得性肺炎的发病率（13．70％）、机械通气时间（7．10±3．75）d、ICU停留时间（12．92±9．93）d和抗生素应用频度（49．66±11．34）均小于对照组，差异具有统计学意义（P〈0．01），观察组和对照组患者医院获得性肺炎的归因病死率（6．51％US6．79％）及多重耐药病原菌感染阳性率（47．26％±53．21％），差异无统计学意义（P〉0．05）。结论集束化诊治策略可有效降低肿瘤重症患者医院获得性肺炎的发病率，缩短住院时间。
Objective To investigate the effect of bundle strategy of diagnosis and treatment on preventing hospital acquired pneumonia in intensive cancer patients. Methods Two hundred and sixty-five patients as control group were treated by regular preventive measures, and 292 cases as intervention group were treated by bundle strategy including the control application of antibiotics, hand hygiene, oral care, isolation of multidrug resistant, eleva- tion of bedside, management of respiratory tract and appropriate sedation and analgesia et al. Compare the hospital acquired pneumonia incidence, attribution mortality, duration of mechanical ventilation, stay-time in ICU, hospital acquired pneumonia antibiotics defined daily doses system and positive rate of multi-drug resistant infection between two groups . Results With the bundle treatment, the decreases of the hospital acquired pneumonia Incidence, duration of mechanical ventilation, stay-time in ICU and hospital acquired pneumonia Antibiotics daily doses system were significant（ P 〈 0.01 ）, and the positive rate of hospital acquired pneumonia attribution mortality and MDR infection were no statistical significance （ P 〉 0.05 ）. Conclusion The bundle strategy of diagnosis and treatment could reduce the hospital acquired pneumonia incidence and the length-time in hospital.
出处
《国际外科学杂志》
2012年第10期688-691,共4页
International Journal of Surgery
关键词
肿瘤
重症监护
肺炎
交叉感染
集束化诊治策略
Neoplasms
Intensive care
Pneumonia
Cross infection
Bundle strategy of diagnosis and treatment
