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龙 苗1 贾叙锋2 邓海波1 黄象丽1 何 平3▲.影响分析理论对老年机械通气患者呼吸机相关性肺炎的预防价值[J].中国现代医生,2021,59(11):163-166
影响分析理论对老年机械通气患者呼吸机相关性肺炎的预防价值
Value of failure model effectiveness analysis in preventing ventilator associated pneumonia in elderly patients with mechanical ventilation
  
DOI:
中文关键词:  影响分析理论  老年  机械通气  呼吸机相关性肺炎
英文关键词:Failure model effectiveness analysis  The elderly  Mechanical Ventilation  Ventilator associated pneumonia
基金项目:四川省护理科研课题(H18045)
作者单位
龙 苗1 贾叙锋2 邓海波1 黄象丽1 何 平3▲ 1.四川省简阳市人民医院呼吸科四川简阳 6414002.四川省简阳市人民医院骨科四川简阳 6414003.四川省简阳市人民医院护理部四川简阳 641400 
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中文摘要:
      目的 探讨影响分析理论(FMEA)的护理干预在老年机械通气患者呼吸机相关性肺炎(VAP)预防中的价值。方法 选取本院2017 年2 月至2019 年3 月收治的92 例机械通气患者作为研究对象采用随机数表法分为观察组和对照组,每组各46 例。对照组行常规护理干预预防VAP,观察组在FMEA 指导下行护理干预预防VAP。比较两组机械通气期间VAP 发生率,两组干预前后氧化应激反应及呼吸力学指标变化[丙二醛(MDA)、超氧化物歧化酶(SOD)、气道峰压(PIP)、气道阻力(AR)],并比较两组机械通气时间及住院时间。结果 观察组干预后VAP发生率为4.35%,显著低于对照组的19.57%,差异有统计学意义(P<0.05)。观察组干预后MDA、PIP、AR 水平显著低于干预前及对照组干预后,差异有统计学意义(P<0.05);观察组干预后SOD 水平显著高于干预前及对照组干预后,差异有统计学意义(P<0.05)。观察组干预后机械通气时间及住院时间显著短于对照组,差异有统计学意义(P<0.05)。结论 FMEA 指导下行护理干预可降低VAP 发生率,缩短老年患者机械通气时间及住院时间,具有较高的临床应用价值。
英文摘要:
      Objective To explore the value of nursing intervention based on failure model effectiveness analysis(FMEA) in preventing ventilator associated pneumonia (VAP) in elderly patients with mechanical ventilation.Methods A total of 92 patients with mechanical ventilation admitted to our hospital from February 2017 to March 2019 were selected as the research objects,and they were divided into the observation group and the control group according to the random number table method each group had 46 cases.The control group was treated with conventional nursing intervention to prevent VAP,while the observation group was treated with nursing intervention to prevent VAP under the guidance of FMEA.The incidence of VAP during mechanical ventilation was compared between the two groups.Meanwhile,the changes of oxidative stress reaction and respiratory mechanics indexes,malondialdehyde (MDA),superoxide dismutase(SOD),peak inspiratory pressure(PIP),airway resistance(AR) before and after intervention were compared between the two groups.In addition,the time of mechanical ventilation and hospitalization in the hospi were compared between the two groups.Results The incidence of VAP in the observation group was 4.35%,significantly lower than 19.57% in the control group,with statistically significant difference (P<0.05).After the intervention,the levels of MDA,PIP and AR levels in the observation group were significantly lower than those in the control group before and after intervention,with statistically significant differences(P<0.05).The SOD level in the observation group after intervention was significantly higher than that before intervention and that in the control group after intervention,with statistically significant difference(P<0.05).After intervention,the time of mechanical ventilation and the hospitalization time in the observation group were significantly chorter than those in the control group,with statistically significant differences(P<0.05).Conclusion Nursing intervention guided by FMEA can reduce the incidence of VAP,shorten the mechanical ventilation time and hospitalization time of elderly patients,which has high clinical application value.
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