The Study Of The Bundle Therapeutic Measures To The Prevention Function Of Ventilater-associated Pneumonia

Objective:Ventilater-associated pneumonia is hospital acquired pneumonia when patients are mechanically ventilated.In the intensive care unit(ICU), effects of preventing ventilator-associated pneumonia by comparing improved bundle therapeutic measures and traditional bundle therapeutic measures not only show their difference but also investigate incidence of a disease to decreasing time of patients living in the ICU.Methods:Patients are selected between 2008.land 2009.12 in the ICU. They were divided into two groups randomly.The measure group is improved bundle therapeutic measures and the control group is traditional bundle therapeutic measures.There are 42 patients in the measure group and 40 patients in the control group. All the patients were severely impaired,but they are healthy former.There was no statistic difference in age,ratio of sex,APACHEII Score.There are the same therapeutic measures as follow:(1) Actively treating primary disease.(2).Actively controlling infection. (3).Protectingmainorgans,reasonablymaintaining nutrition and avoiding needless blood tranfusion.(4).Probably keeping patients partly lying.(5). Reasonably keeping patients calm.Investgating severity of diseases every day, earily stoping using ventilator and displeasing air tube in the trachea through ora and pharynx,earily cutting trachea operation if needing long mechanical ventilation.(6).Preventing deep venous thrombus.(7).Avoiding hospital intercrossed infection.(8).Enhancing administration in the ICU.The measure group adds to measures as follow:(1). Toothbrushing twice every day.(2).2%Chlorhexidine and 4%NaHCO3 used in turn to clean in the ora and pharynx every 50ml every 6h.(3).Suction every 1h.(4).Keeping 0.45%NaCL droping. The control group adds to 4%NaHCO3 used bid every day to clean in the ora and pharynx and suction in the ora and pharynx every 4h,no taking brushing tooth and 0.45%NaCL droping.Both groups minitoring signs in their lives,SpaO2, Blood routine examination,X-ray chest and Pathogens of Lower respiratory tract.Accroding to "Hospital-acquired pneumonia diagnosis and treatment guidelines" (draft), diagnosing VAP and contrasting their difference incidence and time of patients living in the ICU.Results:The measure group and the control group do not differ in age,sex and APACHEII evaluating in the statistics. Incidence in the measure group is 21.4%and it take patients average time of patients 15.61±7.00day to live in the ICU; Incidence in the control group is 47.5%and it take patients average time of patients 21.45±9.70day. Their incidence significantly differs in the statistics.Conclusion:In the ICU, improved bundle therapeutic measures can obviously reduce incidence of ventilater-associated pneumonia and decreasing time of patients living in the ICU,moreover effect of the measure is worth trusting.