摘要
目的探讨高血压脑出血患者实施预见性护理对肺部感染的控制效果,为临床护理提供依据。方法选择2013年10月-2014年1月高血压脑出血住院患者80例,随机分为普通组和护理组,各40例,普通组实施常规护理,护理组患者在普通组基础上实施预见性呼吸道护理、肺炎预防护理等,对比两组患者护理后发生肺部感染率,病原菌分布及耐药性。结果普通组患者发生肺部感染9例发生率22.50%,护理组患者发生肺部感染2例发生率5.00%,护理组明显优于普通组,差异有统计学意义(χ2=13.291,P<0.05);11例感染患者分离培养出19株病原菌,肺炎克雷伯菌7株占36.84%、金黄色葡萄球菌6株占31.58%、铜绿假单胞菌4株占21.05%,金黄色葡萄球菌对多种抗菌药物存在100.00%的耐药,但对万古霉素无耐药性;铜绿假单胞菌对氨苄西林、头孢曲松、头孢他啶、左氧氟沙星有较高的耐药性,但对美罗培南的敏感率为68.50%;肺炎克雷伯菌对氨苄西林、哌拉西林/他唑巴坦、头孢他啶、头孢曲松耐药率很高。结论针对高血压脑出血患者实施预见性护理可以有效降低肺部感染发生率,临床效果确切,值得推广应用。
OBJECTIVE To explore the effect of predictive nursing care on prevention of pulmonary infections in pa-tients with hypertensive cerebral hemorrhage so as to provide guidance for clinical nursing .METHODS A total of 80 patients with hypertensive cerebral hemorrhage who were treated from Oct 2013 to Jan 2014 were enrolled in the study and randomly divided into the conventional group and the nursing group ,with 40 cases in each ;the con-ventional group was treated with the conventional nursing ,while the nursing group was treated with additional predictive respiratory tract nursing and pneumonia prevention nursing based on the conventional group ;the inci-dence of pulmonary infections ,distribution ,and drug resistance of pathogens were observed and compared be-tween the two groups .RESULTS After the nursing ,the incidence of pulmonary infections was 5 .00% （2 cases ） in the nursing group ,significantly lower than 22 .5% （9 cases） in the conventional group ,there was significant difference（χ2 = 13 .291 ,P〈 0 .05） .Totally 19 strains of pathogens have been cultured from 11 cases of infections , there were 7 （36 .84% ） strains of K lebsiella pneumoniae ,6 （31 .58% ） strains of Staphylococcus aureus ,and 4 （21 .05% ） strains of Pseudomonas aeruginosa .The drug resistance rate of the S .aureus to a variety of antibiotics was 100 .00% ,but the drug resistance rate to vancomycin was 0 ;the P .aeruginosa was highly resistant to ampi-cillin ,ceftriaxone ,ceftazidime ,and levofloxacin ,however ,the drug susceptibility rate to meropenem was 68 . 50% ;the K .pneumoniae was highly resistant to ampicillin ,piperacillin-tazobactam ,ceftazidime ,and ceftriaxone . CONCLUSION The implementation of predictive nursing care can effectively reduce the incidence of pulmonary in -fections in the patients with hypertensive cerebral hemorrhage and achieve exact clinical effect ,and it is worthy to be promoted .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第6期1318-1319,1325,共3页
Chinese Journal of Nosocomiology
基金
高等学校博士学科点专项科研基金资助项目(200804220042)
关键词
高血压脑出血
肺部感染
预见性护理
Hypertensive cerebral hemorrhage
Pulmonary infection
Predictive nursing care
