一例重症脑出血术后呼吸机相关性肺炎的护理.docxVIP

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摘要

呼吸机相关性肺炎(VAP)是在进行机械通气后48小时到拔管后48小时之间发生的肺炎。VAP的发生率为9%-70%，死亡率为50%-69%。机械通气每增加一天，发生VAP的几率也会随之增加[1]。目的：总结一例重症脑出血术后病人并发呼吸机相关性肺炎病例的护理，为临床此类患者的护理措施提供实质性指导。方法：回顾其临床资料以及治疗、转归情况，并总结其护理要点。结果：通过积极的治疗和护理，患者肺部感染没有持续扩散，有好转倾向，病情得到一定控制，为其后续治疗原发脑出血和颅内感染奠定了良好的基础。结论：重症脑出血术后气管插管患者发生VAP后要高度重视肺部感染的护理，避免护理不及时，使患者感染加重，引发更加严重的后果。在系统治疗的同时，根据患者病情为患者制定个体化护理方案，可以有效的控制感染，促进患者康复，值得临床实践与探讨。

关键词：呼吸机相关性肺炎；护理；机械通气

ABSTRACT

Ventilatorassociatedpneumonia(VAP)isapneumoniathatoccursbetween48hoursaftermechanicalventilationand48hoursafterextubation.TheincidenceofVAPis9%-70%,andthemortalityrateis50%-69%.TheprobabilityofVAPoccurringincreaseswitheachadditionaldayofmechanicalventilation[1].Objective:Tosummarizethenursingcareofapostoperativepatientwithseverecerebralhemorrhagecomplicatedwithventilator-associatedpneumonia,andprovidesubstantiveguidanceforthenursingmeasuresofsuchpatientsinclinicalpractice.Method:Reviewitsclinicaldata,treatment,andoutcome,andsummarizeitsnursingpoints.Result:Throughactivetreatmentandcare,thepatientspulmonaryinfectiondidnotcontinuetospreadandhadatendencytoimprove.Theconditionwasundercertaincontrol,layingagoodfoundationforthesubsequenttreatmentofprimarycerebralhemorrhageandintracranialinfection.Conclusion:AfterundergoingtrachealintubationforpatientswithseverecerebralhemorrhagewhoexperienceVAP,highattentionshouldbepaidtothecareoflunginfectionstoavoiduntimelycare,exacerbatingtheinfectionandcausingmoreseriousconsequences.Atthesametimeassystematictreatment,developingpersonalizednursingplansforpatientsbasedontheirconditioncaneffectivelycontrolinfectionandpromotepatientrecovery,whichisworthclinicalpracticeandexploration.

Keywords:Ventilator-associatedpneumonia;Postoperativehypertensiveintracerebralhemorrhage;mechanicalventilation

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