摘要
目的 探讨多学科协作与问题清单结合的综合护理策略在静脉-静脉体外膜肺氧合(veno-venous extracorporeal membrane oxygenation,VV-ECMO)管理中的应用效果。方法 采用前后对照研究设计,共纳入98例VV-ECMO患者。选取2022年12月—2023年5月的49例患者为对照组,接受标准VVECMO护理。选取2023年6—11月的49例患者为观察组,实施多学科协作与问题清单结合的综合护理策略。比较两组患者并发症发生率、氧合水平和肺功能、住院时间和重返ICU率、活动水平的情况。结果 干预后,观察组患者并发症发生率低于对照组,差异有统计学意义(P<0.05);观察组患者氧合水平和肺功能优于对照组,住院时间短于对照组,重返ICU率低于对照组,差异均有统计学意义(P<0.05)。观察组患者的MRC评分和IMS评分均高于对照组,ICU-AW发生率低于对照组,差异均具有统计学意义(P<0.05)。结论 多学科协作与问题清单结合的综合护理策略能够有效降低VV-ECMO患者的并发症发生率,改善氧合水平、肺功能及肌力,缩短住院时间,提高患者活动能力。
Objective To explore the application effect of a comprehensive nursing strategy combining multidisciplinary collaboration and a problem list in veno-venous extracorporeal membrane oxygenation(VVECMO)management.Methods A pre-post control study design was used,and a total of 98 VV-ECMO patients were included.Forty-nine patients admitted from December 2022 to May 2023 were selected as the control group and received standard VV-ECMO care.Another 49 patients admitted from June to November 2023 were selected as the observation group and received a comprehensive nursing strategy combining multidisciplinary collaboration and a problem list.The incidence of complications,oxygenation levels and lung function,length of hospital stay and ICU readmission rate,and activity levels between the two groups of patients were compared.Results After the intervention,the incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The oxygenation levels and lung function in the observation group were better than those in the control group,the length of hospital stay in the observation group was shorter than that in the control group,the ICU readmission rate in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).The scores of MRC and IMS in the observation group were higher than those in the control group,the incidence of ICU-AW in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion The comprehensive nursing strategy combining multidisciplinary collaboration and a problem list can effectively reduce the incidence of complications in VV-ECMO patients,improve oxygenation levels,lung function,and muscle strength,shorten hospital stay,and enhance patients'mobility.
作者
王颜芳
丛颖
李虎
邵龙辉
侯六生
WANG Yanfang;CONG Ying;LI Hu;SHAO Longhui;Hou Liusheng(Zhongshan People's Hospital,Zhongshan 528400,China)
出处
《护理实践与研究》
2025年第12期1883-1891,共9页
Nursing Practice and Research
基金
广东省卫生健康委员会医学科研基金立项项目(编号:A2023334)。
关键词
静脉-静脉体外膜肺氧合
问题清单
多学科协作
综合护理策略
ICU获得性衰弱
并发症预防
重症护理
Veno-venous extracorporeal membrane oxygenation
Problem list
Multidisciplinary collaboration
Comprehensive nursing strategy
ICU-acquired weakness
Complication prevention
Intensive care
