【摘要】 目的观察使用自制床角量角器准确抬高机械通气病人床头对呼吸机相关性肺炎(VAP)发生率的影响。方法自制床头抬高角度量角器,其为三角形木块,角度分别为30°、60°和90°。将61例机械通气病人随机分为对照组和研究组。对照组采用目视估计法抬高床头角度,研究组使用自制床角量角器评估法。统计两组床头抬高的角度、患者VAP发生率及胃液、咽拭子和支气管内分泌标本微生物学检查结果。结果对照组床头抬高≥30°826例次,占测量次数的63.3%,而研究组床头抬高均为30°以上;对照组发生VAP 17例,占53.1%,研究组发生VAP 7例,占24.1%,两组比较差异有显著意义。患者胃液、咽拭子和支气管内分泌同种细菌检出率,对照组为69.6%,研究组为37.5%。结论自制床角量角器能保证床头抬高角度的准确性,有助于降低返流误吸和VAP的发生率。更多还原

【Abstract】 Objective To observe the effect of using self-made protractor to measure the angle of head-of-bed elevation to reduce in the rate of ventilator-associated pneumonia(VAP). Method Self-made bed elevation angle protractor is a triangular pieces of wood,marked with angle of 30,60 and 90 degrees.61 cases of mechanical ventilation patients were randomly divided into control group and study group.Nurses elevated the head-of-bed by visual estimation in control group,nurses elevate the head-of-bed with self-made protractor in study group.The bed elevation angle,the positive rate of same bacterial culture in patients’ gastric juice,throat swab specimens,bronchial secretion liquid and incidences of VAP between the 2 groups were recorded and analyzed.Result Cases of head-of-bed elevation more than 30 degrees in the control group were 826 cases(63.3%),while all the cases in the study group were above 30 degrees bed elevation.Cases of VAP in control group is 17(53.1%) and 7(24.1%) in study group,the difference of VAP incidence between the two groups was statistically significant.The same positive rate of the bacteria culture in gastric juice,throat swab and bronchial secretion liquid were 69.6%,50% respectively.Conclusion Self-made protractor can guarantee the accuracy of head-of-bed elevation angle to help reduce the incidence of reflux aspiration and VAP.更多还原