牛牛游戏厅安卓,{原始关键词}

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                  • 当前位置: 代写一篇论文多少钱 > 医学论文 > 早产儿综合性护理预防呼吸机相关性肺炎

                    早产儿综合性护理预防呼吸机相关性肺炎

                    时间:2019-02-08 10:53作者:覃倩梅 张玲艳 陆兆美
                    本文导读:这是一篇关于早产儿综合性护理预防呼吸机相关性肺炎的文章,综合护理干预应用于早产儿机械通气中可较好地预防呼吸机相关性肺炎的发生,促进患儿康复,缩短机械通气时间和住院时间,不仅提高早产儿存活率,同时还可减轻家属压力和负担。

                      摘    要: 牛牛游戏厅安卓,{原始关键词}目的 探讨综合护理预防早产儿呼吸机相关性肺炎的临床效果。方法 选取2016年1月至2018年10月该院收治的100例早产儿作为研究对象,均行呼吸支持治疗。按照护理方法不同将其分为对照组与观察组,每组50例,对照组给予常规治疗与护理干预;观察组在对照组基础上实施综合护理干预。记录2组呼吸机使用时间和平均住院时间,比较2组呼吸机相关性肺炎发生率,调查2组家属对护理服务的满意度。结果 观察组患儿呼吸机使用时间和平均住院时间均明显短于对照组,差异均有统计学意义(P<0.05)。观察组患儿治疗期间呼吸机相关性肺炎发生率明显低于对照组,差异有统计学意义(P<0.05)。观察组患儿家属对护理服务的满意度明显高于对照组,差异有统计学意义(P<0.05)。结论 综合护理干预可有利于预防早产儿呼吸机相关性肺炎的发生,缩短患者呼吸机使用时间,促进其康复,缩短其住院时间,提高家属满意度。

                      关键词:牛牛游戏厅安卓,{原始关键词} 早产儿; 机械通气; 呼吸机相关性肺炎; 综合护理;

                      ZAOCHANERYINQICHUSHENGSHIWEIZUYUE,QIHUXIGONGNENGSHANGWEIWANQUANFAYU,YINCI,ZAOCHANERCHUSHENGHOUDUOSHUXUJIESHOUHUXIZHICHIYIBAOZHENGQILIANGHAODETONGQI[1]。RANER,ZAIZAOCHANERHUXIZHICHIGUOCHENGZHONGCUNZAIJIAODUOFENGXIANYINSU,YINCIYIYINFAGEZHONGBINGFAZHENG,QIZHONGHUXIJIXIANGGUANXINGFEIYANSHIZAOCHANERHUXIZHICHIZHONGCHANGJIANDEBINGFAZHENG,YIDANHUANERFASHENGGAIBINGFAZHENGZEHUIZHITUOJIKUNNAN,YANZHANGZHILIAOSHIJIAN,YINGXIANGQIYUHOU[2]。YINCI,ZUOHAOHUXIZHICHIGUOCHENGZHONGHULIGANYUJUYOUSHIFENZHONGYAODEZUOYONG。BENYANJIUDUIBENYUANSHOUZHIDEZAOCHANERSHISHIZONGHEHULIGANYU,QUDELEJIAOHAODEXIAOGUO,XIANBAODAORUXIA。

                      1、 资料与方法

                      1.1、 一般资料

                    牛牛游戏厅安卓,{原始关键词}   XUANQU2016NIAN1YUEZHI2018NIAN10YUEBENYUANSHOUZHIDE100LIZAOCHANERZUOWEIYANJIUDUIXIANG,JUNXINGHUXIZHICHIZHILIAO。ANZHAOHULIFANGFABUTONGJIANGQIFENWEIGUANCHAZUYUDUIZHAOZU,GE50LI。BENCIRUXUANZHEJUNWEIZAOCHANER,XINGJIXIETONGQIZHILIAO,TAILINGXIAOYU37ZHOU,JIXIETONGQISHIJIANDAYU2d。PAICHUFEIBUYANZHENGHUOGANRAN、JIXIETONGQISHIJIANXIAOYU2d、XIANTIANXINGJIBINGDENG。GUANCHAZUHUANERZHONGNAN27LI,NV23LI;TAILING30~36ZHOU,PINGJUN(33.6±2.1)ZHOU;CHUSHENGTIZHONG1 521~2 512g,PINGJUN(1 998.6±486.7)g。DUIZHAOZUHUANERZHONGNAN28LI,NV22LI;TAILING31~36ZHOU,PINGJUN(33.8±2.2)ZHOU;CHUSHENGTIZHONG1 517~2 523g,PINGJUN(1 999.2±487.1)g。2ZUHUANERXINGBIE、TAILINGJICHUSHENGTIZHONGBIJIAO,CHAYIJUNWUTONGJIXUEYIYI(P>0.05),JUYOUKEBIXING。

                      1.2、 方法

                      1.2.1、 护理方法

                      DUIZHAOZUJIYUCHANGGUIZHILIAOYUHULIGANYU,YANGEANZHAOYIYUANXIANGGUANGUIZHANGZHIDUJIYUHULI,BINGZUNYIZHUYONGYAO,ZIXIGUANCHAHUANERGEXIANGSHENGMINGTIZHENG,BINGXIANGXIJILU,DUICHUXIANDEWENTIJISHIXIANGYISHENGHUIBAO,YIBIANYUYISHENGJISHIDIAOZHENGZHILIAOFANGAN。

                      观察组在对照组基础上实施综合护理干预,做好保护性通气策略,小潮气量在6~8mL/kg,保持较低峰压,逐渐提高呼气末正压通气,允许性高碳酸血症;及时吸取痰液培养,了解细菌状况以指导临床合理治疗,早期进行1次痰液培养,撤机时再次做痰液培养和气管插管终端分泌物培养。严格按照相关规范执行操作,尽量减少侵入性操作,严格执行无菌操作流程,采集动脉血气时要做到一次性采集成功。血气正常时每天采集1次,血气不正常时每1~2小时采集1次微量血气。抬高患儿床头,让其取头高位30°,密闭式吸痰,严格执行手卫生制度,做好口腔护理,每天2次。呼吸环路管理:呼吸机回路管道和雾化器及氧气湿化瓶内无菌液体需做到每24小时更换1次,氧气湿化瓶每天需消毒1次;雾化器和氧气湿化瓶内液体补充前需将剩余液体倒出干净,待清洁后重新装入无菌液体。集水瓶需放置于最低位,及时将冷凝液中冷凝水倒掉。医护人员处理冷凝液后需及时洗手。呼吸道管理:吸痰处理应在患儿病情稳定12h后进行,操作时需做到动作快速且轻柔,吸痰后需及时连接呼吸机。严格按照相关方法进行排痰,避免反复多次抽吸,吸痰管为一次性。做好基础护理,加强营养支持,及时纠正其他指标,避免并发症发生。口腔护理:加强口腔护理,每天2次,根据早产儿口腔pH值来选择合适的口腔护理液。
                     

                    早产儿综合性护理预防呼吸机相关性肺炎
                     

                      1.2.2、 观察指标

                    牛牛游戏厅安卓,{原始关键词}   JILU2ZUHUXIJISHIYONGSHIJIANHEPINGJUNZHUYUANSHIJIAN,BIJIAO2ZUHUXIJIXIANGGUANXINGFEIYANFASHENGLV,CANZHAO《YIYUANHUODEXINGFEIYANZHENDUANHEZHILIAOZHINAN》ZHONGYOUGUANBIAOZHUNZHENDUAN,JIXIETONGQI2dHOU,JINGXIONGBUXXIANPIANJIANCHATISHIXINDEHUOJINXINGXINGFEIJINRUN,FAREHUOTIWENSHENGGAO,XUEYEJIANCHATISHIBAIXIBAOZENGDUO,QIGUANDENGCUNZAINONGXINGFENMIWU。YIYIYUANZIZHIWENJUANDUIXUANQUHUANERJIASHUJINXINGMANYIDUDIAOCHA,RENSHUXUANQUANZHAO1∶1XUANQU,FENWEIMANYI、JIBENMANYI、BUMANYI,MANYIDU=(MANYILISHU+JIBENMANYILISHU)/ZONGLISHU×100%。

                      1.3 、统计学处理

                    牛牛游戏厅安卓,{原始关键词}   YINGYONGSPSS20.0TONGJIRUANJIANJINXINGSHUJUFENXI,JILIANGZILIAOYIBIAOSHI,CAIYONGDULIYANGBENtJIANYAN;JISHUZILIAOYILVHUOGOUCHENGBIBIAOSHI,CAIYONGχ2JIANYAN。P<0.05WEICHAYIYOUTONGJIXUEYIYI。

                      2、 结果

                      2.1、 2组患儿呼吸机使用时间和平均住院时间比较

                    牛牛游戏厅安卓,{原始关键词}   GUANCHAZUHUANERHUXIJISHIYONGSHIJIANHEPINGJUNZHUYUANSHIJIANJUNMINGXIANDUANYUDUIZHAOZU,CHAYIJUNYOUTONGJIXUEYIYI(P<0.05)。JIANBIAO1。

                      表1 2组患儿呼吸机使用时间和平均住院时间比较
                    表1 2组患儿呼吸机使用时间和平均住院时间比较

                      ZHU:-BIAOSHIWUCIXIANG。

                      2.2 、2组患儿治疗期间呼吸机相关性肺炎发生率比较

                    牛牛游戏厅安卓,{原始关键词}   GUANCHAZUHUANERZHILIAOQIJIANHUXIJIXIANGGUANXINGFEIYANFASHENGLV[4.0%(2/50)]MINGXIANDIYUDUIZHAOZU[26.0%(13/50)],CHAYIYOUTONGJIXUEYIYI(χ2=6.812,P=0.000)。

                      2.3、 2组患儿家属对护理服务的满意度比较

                      GUANCHAZUHUANERJIASHUDUIHULIFUWUDEMANYIDUMINGXIANGAOYUDUIZHAOZU,CHAYIYOUTONGJIXUEYIYI(χ2=6.982,P=0.000)。JIANBIAO2。

                      表2 2组患儿家属对护理服务的满意度比较
                    表2 2组患儿家属对护理服务的满意度比较

                    牛牛游戏厅安卓,{原始关键词}   ZHU:YUDUIZHAOZUBIJIAO,χ2=6.982,aP=0.000。

                      3、 讨论

                      JINNIANLAI,SUIZHELINCHUANGYIXUEJISHUDEKUAISUFAZHAN,DITIZHONGZAOCHANERYINHUXIKUNNANZHISILVMINGXIANXIAJIANG,ZAOCHANERCUNHUOLVMINGXIANTIGAO[3]。DANYINZAOCHANERCHUSHENGSHIWEIZUYUE,SUOYIQIHUXIGONGNENGJIAOCHA,QICHUSHENGHOUXUJIYUHUXIJIFUZHUHUXIYIWEICHIQIYOUXIAOHUXI[4]。MUQIAN,JIXIETONGQISHILINCHUANGYOUXIAOWEICHIHUXIDEFANGSHI,KEWEIZAOCHANERTIGONGCHONGZUYANGLIULIANG,TONGSHIHAIKEBAOZHANGHUANERDEDAOANQUANDEFEITONGQI,DANZAOCHANERZAIJIXIETONGQIQIJIANYISHOUJIAODUOYINSUYINGXIANG,SUOYIYIFASHENGGEZHONGBINGFAZHENG,CONGERYINGXIANGQIYUHOU。SUOYI,ZUOHAOZAOCHANERJIXIETONGQIQIJIANHULIGANYUJUYOUZHONGYAOYIYI。

                      HUXIJIZHILIAOZAOCHANERXUBISIWEIYANG,ZHANGQICHUYUPINGWOWEIKEZHIQICHUXIANNAIYEFANLIU,ZENGJIAXIJUNGANRANGAILV,ERCAIYONGTOUGAOWEIZEKEJIANSHAOFANLIU,YOUXIAOYUFANGHUXIJIXIANGGUANXINGFEIYAN,CUJINQIKANGFU,SUODUANQIZHUYUANSHIJIAN[5]。XITANSHIYIZHONGCHUANGSHANGXINGCAOZUO,QIDUIZAOCHANERQIDAONIANMOYOUYIDINGSUNSHANG,CAIYONGKAIFANGSHIXITANBUJINSHOUDAOHUANJINGWURANDENGYINGXIANG,ERQIEHAIHUIYINCAOZUOBUDANGYINQIXIJUNQINRU,ZUIZHONGYINFAGANRAN。BENYANJIUZHONG,CAIYONGMIBISHIXITANBIMIANLEQIDAOKAIFANGERSHOUDAOWAIJIEGEZHONGYINSUDEYINGXIANG,CIWAI,MIBISHIXITANBUXUFANFUGENGHUANXITANGUAN,CONGERJIANSHAOHAOCAIHEZHILIAOSHIJIAN,YOULIYUJIASUHUANERKANGFU,SUODUANQIZHUYUANSHIJIAN[6]。GANRANZUIWEIYOUXIAO、ZHIJIEDEFANGSHISHIJIAQIANGSHOUWEISHENGGUANLI,YAOQIUYIHURENYUANYANGEZHIXINGSHOUWEISHENGZHIDU,CAOZUOQIANHOUHEJIECHUZAOCHANERQIANHOUJUNXUYANGEANZHAOLIUCHENGXISHOU,YANGEYAOQIUYIHURENYUANPEIDAIYICIXINGSHOUTAO,DUITESHUHUANERJINXINGZHILIAOSHIHAIXUCHUANGELIYIHEPEIDAISHOUTAO,MEITIANJINXINGKOUQIANGHULI,BIMIANXIJUNDINGZHI,YUFANGGANRANFASHENG。DINGQIGENGHUANHUXIJIGUANDAO,YOUXIAOYUFANGXIJUNDINGZHI。GENJUTANYEDENGPEIYANGJIEGUOJINXINGHELIZHILIAO,CONGERKEBIMIANNAIYAOXING,TIGAOZHILIAOXIAOGUO,JIASUHUANERKANGFU。HAIYINGZAIYUANFAXINGJIBINGKONGZHIJICHUSHANGJINZAOBAGUANCHEJI,SUODUANZHILIAOSHIJIAN。YANGEZHANGWOJIXIETONGQISHIYINGZHENG,CHEDICONGYUANTOUSHANGDUJUEHUXIJIXIANGGUANXINGFEIYANDEFASHENG,ZUIDAXIANDUBAOZHANGHUANZHEANQUAN[7]。MEITIANCAIYONGSHENGLIYANSHUIDUIHUANERKOUQIANGJINXINGQINGJIE,DANZAICASHIKOUQIANGSHIYAOZUODAODONGZUOQINGROU,TONGSHIHAIXUBUDINGQICHOUCHAHUANERKOUQIANGQINGJIEZHUANGKUANG。DINGQIGENGHUANTIWEI,MEIGE2hGENGHUAN1CI,RUYOUCEWOWEI、ZUOCEWOWEIDENG,BINGZUOHAOTIWEIGENGHUANJILU。QINGQINGPAIJIZAOCHANERBEIBU,ZUOHAOTOUBUBAOHUCUOSHI,DINGQIXITANYIBAOCHIQIHUXIDAOTONGCHANG,XITANSHIZUOHAOKESOUFANSHEPINGGU,JISHIDIAOZHENGHUXIJICANSHU[8]。DUIZAOCHANERLAISHUO,QIGEXIANGHUXIGONGNENGDENGSHANGWEIFAYUWANQUAN,QIEZISHENDIKANGLIJIAOCHA,YINCIYIFASHENGGEZHONGBINGFAZHENG,QIEYIBEIBINGYUANJUNRUQINERYINFAGANRAN,YIDANHUANERFASHENGGANRANBUJINYINGXIANGQIYUHOU,HAIHUIYANZHANGQIZHUYUANSHIJIAN,ZENGJIAHOUXUZHILIAONANDU,JIJIASHUDAILAIJIDADEJINGJIYALI,SUOYI,JIJIJIYUZONGHEHULIKEYOUXIAOYUFANGBINGFAZHENGDEFASHENG,TIGAOZHILIAOXIAOGUO。ZAOCHANERYINFENMIANSHIJIANJIAOZAO,HUXIGONGNENGDENGJIAOZHENGCHANGYUNZHOUXINSHENGERCHA,HUXINIANMODENGMIANYIFANGYUGONGNENGJIAOCHA,XINGJIXIETONGQIZHILIAOSHI,YIYINGEZHONGCAOZUODAIRUBINGYUANJUN,SUOYIYIHURENYUANYAOJIAQIANGGUANCHA,YANMIGUANCHAHUANERBINGQING,BINGDINGQIXINGTANYEDENGXIJUNPEIYANG,ZUODAOZAOFAXIAN、ZAOZHILIAO,JIANSHAOFENGXIANYINSUDEFASHENG。HULIRENYUANJIJIPINGGUZAOCHANERBINGQING,GENJUHUANERSHIJIQINGKUANGLAIJINXINGHULI,TONGSHIYISHENGGENJUPINGGUJIEGUOLAIJISHIDIAOZHENGZHILIAOFANGAN,CUJINHUANERKANGFU,TIGAOHUANERJIASHUMANYIDU。

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