摘要
目的:初步探索常规护理基础上,加用腹部按摩护理对于呼吸机相关性肺炎的作用。方法:选择2014年6月-2015年6月本院重症医学科机械通气患者101例,根据护理方法的不同分为观察组50例与对照组51例,所有患者均行连续肠内营养,对照组给予常规护理及VAP预防措施,观察组在对照组基础上给予2次/d的腹部按摩,持续15 min/次。对比两组患者VAP发生率、胃内残留量、腹围变化及呕吐腹胀发生率。结果:观察组平均入住ICU时间为(5.1±1.4)d,对照组为(4.5±1.5)d,观察组长于对照组,比较差异有统计学意义(P<0.05)。与基础胃内残留量及腹围比较,入住ICU最后1 d胃内残留量增加的比例观察组为19.6%,腹围增加比例为15.7%,均低于对对照组的40.0%和38.0%,差异均有统计学意义(P<0.05)。观察组胃内残留量较首次测量时减少(10.1±4.9)m L,腹围减少(3.1±0.8)cm;对照组增加(11.7±3.8)m L,腹围增加(5.3±0.6)cm,差异均有统计学意义(P<0.05)。两组发生呕吐、腹胀的患者比较,差异无统计学意义(P>0.05)。观察组仅有1例(2.0%)发生VAP,对照组6例(12.0%)发生VAP,两组比较差异有统计学意义(P=0.047)。结论:行肠内营养的机械通气患者,2次/d的腹部按摩护理可有效降低胃内残留量、腹胀发生率及呼吸机相关性肺炎的发生风险。
Objective：To identify the effect of abdominal massage administered to the development of ventilator-associated pneumonia（VAP） on the basis of routine nursing care.Method：One hundred and one ICU patients with mechanical ventilation from June 2014 to June 2015 were prospectively selected and divided into the observation group of 51 cases and the control group of 50 cases according to the different nursing methods.All patients underwent continuous enteral nutrition,the control group was given routine nursing care and preventive measures of VAP,the observation group was given times a day of abdominal massage on the basis of the control group, each lasting 15 min.The incidence of VAP,vomiting,gastric residual volume and abdomen circumference of the two groups were compared.Result：The ICU admission time was（5.1±1.4）d in the observation group,which was longer than（4.5±1.5）d in the control group, the difference was statistically significant（P〈0.05）.At the end of monitoring days,the amount of gastric residual volume and abdominal circumference measurement increase of patients in the observation group were 19.6% and 15.7% respectively,which were less than 40.0% and 38.0% of the control group,the differences were statistically significant（P〈0.05）.The amount of gastric ally residual volume and abdominal circumference in the observation group were（10.1±4.9）m L and（3.1±0.8）cm decreased compared with the foundation measurements,while which were（11.7±3.8）m L and（5.3±0.6）cm increased in the control group,the differences were statistically significant（P〈0.05）.The difference of vomiting and abdominal distension had no statistic significant between the two groups（P〉0.05）.One patient（2.0%） in the observation group occurred VAP,while which were 6 patients（12.0%） of the control group, the difference were statistically significant（P=0.047）.Conclusion：Abdominal massage twice a day can effectively reduce the gastric resiclual volume,abdominal distension and the
出处
《中国医学创新》
CAS
2016年第13期79-82,共4页
Medical Innovation of China
关键词
腹部按摩
肠内营养
呼吸机相关肺炎
护理
Abdominal massage
Enteral feeding
Ventilator-associated pneumonia
Nursing
