摘要
目的探究细菌性肺炎患儿实行闭环式护理管理模式后患儿临床症状、呼吸道菌群及疾病复发的情况。方法选取2016年5月至2018年11月我院收治的113例细菌性肺炎患儿为研究对象,随机分为观察组(n=55)和对照组(n=58)。两组患儿均给予抗生素治疗及常规护理。观察组患儿在常规护理基础上应用闭环式护理。观察两组患儿各主要临床症状缓解时间及住院时间、治疗有效率、治疗前及治疗1周后呼吸道菌群分布情况及治疗结束后6个月内细菌性肺炎复发率。结果观察组患儿体温恢复时间、咳嗽及咳痰缓解时间及住院时间均短于对照组(均P<0.05)。观察组患儿呼吸道革兰阳性菌中以肺炎链球菌(48.39%,15/31)、金黄色葡萄球菌(38.71%,12/31)为主,革兰阴性菌中以肺炎克雷伯菌(31.82%,21/66)、大肠埃希菌(34.85%,23/66)为主。观察组患儿治疗1周后呼吸道革兰阳性菌分布比例(33.33%,12/36)低于对照组(37.04%,20/54)。治疗1周后观察组患儿呼吸道细菌总检出数低于对照组(P<0.05)。观察组患儿治疗结束后6个月内复发率为3.64%(2/55),对照组为12.07%(7/58),二者比较差异无统计学意义(P>0.05)。观察组患儿治疗有效率为89.09%(49/55),高于对照组的72.41%(42/58)。结论细菌性肺炎患儿呼吸道菌群以肺炎链球菌、金黄色葡萄球菌、肺炎克雷伯菌及大肠埃希菌为主。应用闭环式护理管理模式后,可明显改善细菌性肺炎患儿各临床症状,缩短症状缓解时间,抑制呼吸道革兰阳性菌群生长,但对治疗后复发率影响不大。
Objective To investigate the effect of closed-loop nursing on the symptoms, respiratory tract microflora and recurrence of bacterial pneumonia in children. Methods A total of 113 children with bacterial pneumonia in our hospital from May 2016 to November 2018 were enrolled, and randomly divided into the observation group(n=55) or control group(n=58). Both groups were given antibiotic treatment and routine nursing;based on this, the observation group received the closed-loop nursing. The time to remission of main clinical symptoms, hospitalization time, efficiency rate, distribution of respiratory tract flora, and recurrence rate were observed. Results The time to recovery of body temperature, times to remission of cough and expectoration and hospitalization time in the observation group were shorter than those in the control group(all P<0.05) respectively. In the observation group, Streptococcus pneumoniae(48.39%, 15/31) and Staphylococcus aureus(38.71%, 12/31) were the most common Gram-positive bacteria in respiratory tract, while Klebsiella pneumoniae(31.82%, 21/66) and Escherichia coli(34.85%, 23/66) were the most common Gram-negative bacteria. The distribution of Gram-positive bacteria in the observation group one week after treatment was lower than that in the control group(33.33% vs 37.04%, P<0.05). The total number of strains in the observation group one week after treatment was significantly lower than that in the control group(P<0.05). There was no significant difference in the recurrence rate within 6 months after treatment between the two groups(3.64% vs 12.07%, P>0.05). The efficiency rate in the observation group was higher than that in the control group(89.09% vs 72.41%, P<0.05). Conclusion Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli are the main pathogens of bacterial pneumonia in children. Closed-loop nursing can significantly improve the clinical symptoms of children with bacterial pneumonia, shorten the time to remission of symptoms, and inhibit the growth of Gram-positive bacteria in respiratory tract, but has little effect on the recurrence rate after treatment.
作者
寿晓霞
郭妍妍
SHOU Xiaoxia;GUO Yanyan(Department of Pediatrics,the Affiliated Hospital of Inner Mongolia Medical University,Huhehot Inner Mongolia 010050,China)
出处
《中国微生态学杂志》
CAS
CSCD
2019年第12期1420-1423,1430,共5页
Chinese Journal of Microecology
关键词
闭环式护理
细菌性肺炎
呼吸道菌群
复发率
Closed-loop nursing
Bacterial pneumonia
Respiratory tract flora
Recurrence rate
