摘要
目的探讨在重症医学科应用自行设计的核查单进行管理,对机械通气患者预后的影响。方法选择我院重症医学科2018年7月~2020年3月所有机械通气患者为研究对象。按时间段分组,研究组选择2019年7月~2020年3月机械通气患者204例,对照组选择2018年7月~2019年3月机械通气患者204例。研究组患者按科室机械通气治疗流程给予机械通气治疗,日常三级医师查房指导管理,通过自行设计机械通气治疗核查单,对机械通气患者治疗过程采用核查单化管理。对照组患者按科室机械通气治疗流程给予机械通气治疗,日常三级医师查房指导管理,未应用核查单管理。比较两组患者机械通气时间、ICU住院时间、呼吸机相关性肺炎(VAP)发生率、气管插管拔管后48 h再插管率、死亡率之间的差异。结果研究组机械通气时间、ICU住院时间短于对照组,差异有统计学意义(P<0.05);VAP发生率、减低气管插管拔管后48 h再插管率低于对照组,差异有统计学意义(P<0.05);两组死亡率比较,差异无统计学意义(P>0.05)。结论通过应用自行设计的机械通气治疗核查单进行管理,能缩短机械通气患者机械通气时间、ICU住院时间,降低VAP发生率、气管插管拔管后48 h再插管率,保证患者安全,临床值得推广。
Objective To explore the effect of self-designed checklist on the prognosis of patients with mechanical ventilation.Methods From July 2018 to March 2020,all patients with mechanical ventilation were selected as the study subjects.According to the time period,the study group selected 204 patients with mechanical ventilation from July 2019 to March 2020,and the control group selected 204 patients with mechanical ventilation from July 2018 to March 2019.The patients in the study group were treated with mechanical ventilation according to the treatment process of mechanical ventilation in the department,and the daily three-level doctor rounds to guide the management.By designing the checklists of mechanical ventilation treatment,checklists were used to manage the treatment process of patients with mechanical ventilation.In the control group,patients were treated with mechanical ventilation according to the treatment process of mechanical ventilation in the department,and the daily three-level doctor rounds for guidance and management,but the checklist management was not used.The differences of mechanical ventilation time,ICU hospitalization time,incidence of ventilator-associated pneumonia(VAP),reintubation rate 48 h after tracheal intubation and extubation,and mortality between the two groups were compared.Results The mechanical ventilation time and ICU hospitalization time in the study group were shorter than those in the control group,the differences were statistically significant(P<0.05);the incidence of VAP and the rate of reintubation 48 h after extubation were lower than those in the control group,the differences were statistically significant(P<0.05);the mortality showed no statistically significant difference in the two groups(P>0.05).Conclusion The self-designed mechanical ventilation treatment checklist can shorten the time of mechanical ventilation and ICU hospitalization,reduce the incidence of VAP and the rate of reintubation 48 h after extubation,ensure the safety of patients,it is worth popularizing.
作者
梁德坚
黄如文
朱江斐
蒋勇
邓光进
朱亚容
肖仁威
LIANG De-jian;HUANG Ru-wen;ZHU Jiang-fei;JIANG Yong;DENG Guang-jin;ZHU Ya-rong;XIAO Ren-wei(Department of Critical Medicine,Yingde People′s Hospital,Guangdong Province,Qingyuan513000,China)
出处
《中国当代医药》
2020年第24期72-75,共4页
China Modern Medicine
基金
广东省清远市科技计划项目[(2019)24号20]。
关键词
核查单
机械通气
气管插管
再插管率
呼吸机相关性肺炎
Checklist
Mechanical ventilation
Endotracheal intubation
Reintubation rate
Ventilator-associated pneumonia
