重症监护病房呼吸机相关肺炎集束化干预效果

Effect of bundle intervention on ventilatorassociated pneumonia in an intensive care unit

摘要:

目的探讨集束化干预措施预防呼吸机相关肺炎（VAP）的效果。方法监测2012年1月—2013年12月入住某综合医院重症监护病房（ICU）的患者，2012年1—12月的患者为对照组，2013年1—12月的患者为干预组（采取集束化干预措施），比较两组患者呼吸机使用率及VAP发病率。结果共监测患者4 560例，干预组2 608例，对照组1 952例。呼吸机使用率干预组为53.95%，对照组为61.17%，干预组呼吸机使用率低于对照组，差异有统计学意义（χ2=65.756，P＜0.01）。干预组VAP发病率为13.00‰，对照组为19.56‰，干预组VAP发病率低于对照组，差异有统计学意义（χ2=4.649，P=0.031）。VAP类型比较，干预组迟发型VAP所占比例高于对照组（41.82‰ VS 24.59‰）。结论集束化干预措施有助于减低ICU患者VAP发病率。

Abstract:

ObjectiveTo evaluate the effect of bundle intervention measures on preventing ventilatorassociated pneumonia (VAP).MethodsPatients who were admitted to an intensive care unit(ICU) of a hospital from January 2012 to December 2013 were monitored, patients from January to December 2012  were as control group,  while from January to December 2013 were as intervention group (bundle intervention measures were implemented). Usage rate of ventilators and incidence of  VAP  between two groups were compared.ResultsA total of 4 560 patients were monitored, 2 608  in  intervention group and 1 952 in control group. Usage rate of ventilators in intervention group was lower than control group (53.95% vs 61.17%； χ2=65.756，P＜0.01）. Incidence of VAP per 1 000 ventilator days in intervention group was lower than control group (13.00‰ vs 19.56‰； χ2=4.649，P=0.031）. Percentage of lateonset VAP per 1 000 ventilator days in tervention group was higher than control group（41.82‰ vs 24.59‰）.ConclusionBundle intervention measures are helpful for reducing the incidence of  VAP in ICU patients.