集束化预防策略在预防新生儿呼吸机相关性肺炎的研究

林福忠 严争 王健 危夷

[摘要] 目的 探讨集束化预防策略在预防新生儿呼吸机相关性肺炎的作用。方法 便利选择2017年6月—2019年5月行机械通气的新生儿120例，采用数字法分为对照组和观察组各60例。对照组接受常规护理，观察组在常规护理的基础之上接受集束化预防策略护理。比较两组患儿护理后的两组患儿护理后机械通气时间、NICU住院时间比较、呼吸机相关性肺炎发生率。 结果 治疗后观察组患儿的机械通气时间为﹙92.64±15.23﹚h，NICU住院时间为﹙12.06±2.35﹚d均低于对照组患儿的机械通气时间﹙102.37±23.67﹚h、NICU住院时间﹙14.28±2.17﹚d（t=8.371、6.548，P<0.05）。观察组患儿呼吸机相关性肺炎发生2例、发生率3.33%，低于对照组患儿呼吸机相关性肺炎发生9例、发生率15.00%（t=5.031，P<0.05）。 结论 集束化预防策略在预防新生儿呼吸机相关性肺炎的治疗中能够减少患儿机械通气时间和住院时间，有效降低了新生儿呼吸机相关性肺炎的发生率。

[关键词] 集束化预防;新生儿;呼吸机相关性肺炎

[中图分类号] R5          [文献标识码] A          [文章编号] 1674-0742（2020）01（b）-0076-03

Study on Prevention of Neonatal Ventilator-associated Pneumonia by Clustering Prevention Strategy

LIN Fu-zhong， YAN Zheng， WANG Jian， WEI Yi

Department of Pediatrics， Fuzhou First Hospital， Fuzhou， Fujian Province， 350009 China

[Abstract] Objective To investigate the role of clustering prevention strategy in preventing neonatal ventilator-associated pneumonia. Methods A total of 120 neonates who underwent mechanical ventilation convenient from June 2017 to May 2019 were enrolled in the control group and the observation group. The control group received routine care and the observation group received clustering prevention strategy care based on routine care. The postoperative nursing time， NICU hospitalization time， and ventilator-associated pneumonia were compared between the two groups. Results After treatment， the mechanical ventilation time of the observation group was ﹙92.64±15.23﹚h， and the NICU hospitalization time was ﹙12.06±2.35﹚d， which was lower than the mechanical ventilation time of the control group ﹙102.37±23.67﹚h， and the NICU hospitalization time was ﹙14.28±2.17﹚d（t=8.371， 6.548， P<0.05）. There were 2 cases of ventilator-associated pneumonia in the observation group， the incidence rate was 3.33%， 9 cases were lower than the control group， and the incidence rate was 15.00% （t=5.031， P<0.05）. Conclusion The clustering prevention strategy can reduce the mechanical ventilation time and hospitalization time in the treatment of neonatal ventilator-associated pneumonia， and effectively reduce the incidence of neonatal ventilator-associated pneumonia.

[Key words] Clustering prevention; Newborn; Ventilator-associated pneumonia

呼吸機相关性肺炎是指患者在使用机械通气的48 h后或者拔管的48 h内出现的肺炎，是机械通气中严重的并发症之一，致死率高达51.36%[1]。医源性因素是引发新生儿呼吸机相关性肺炎的重要致病因素，所以预防护理能够起到良好的预防效果。因此，该文2017年6月—2019年5月收治的行机械通气的新生儿120例作为研究对象，探讨集束化预防策略在预防新生儿呼吸机相关性肺炎的作用。报道如下。