多维度协同护理对ICU脑出血患者肺部感染 预防及整体预后的影响

The Impact of Multidimensional Collaborative Care on the Prevention of Pulmonary Infection and Overall Prognosis in ICU Patients with Cerebral Hemorrhage

摘要: 目的：构建并验证一套多维度协同护理方案在预防重症监护室(ICU)脑出血患者肺部感染及改善其整体预后中的综合效果。方法：采用前瞻性研究方法，选取2023年1月至2024年4月我院ICU收治的64例脑出血患者，随机分为对照组与观察组，各32例。对照组实施常规护理，观察组实施整合了风险评估、结构化集束干预、系统质量控制及早期康复促进的多维度协同护理方案。比较两组患者肺部感染发生率、机械通气时间、ICU住院时间，并采用美国国立卫生研究院卒中量表(NIHSS)、日常生活活动能力量表(ADL)及简明健康状况调查表(SF-36)评估患者神经功能、日常生活能力及生活质量。结果：干预后，观察组患者肺部感染发生率(0% vs. 15.63%)及总并发症发生率(6.25% vs. 34.38%)均显著低于对照组(P < 0.05)。观察组机械通气时间[(7.30 ± 1.25) d vs. (15.10 ± 1.18) d]及ICU住院时间[(16.23 ± 1.25) d vs. (23.10 ± 3.09) d]均显著短于对照组(P < 0.05)。同时，观察组NIHSS评分显著低于对照组，ADL及SF-36各维度评分均显著高于对照组，差异均有统计学意义(P < 0.05)。结论：多维度协同护理方案能够通过系统性的风险管控与结构化干预，有效构建肺部感染防线，显著降低感染风险，并协同促进神经功能与生活质量的全面改善，临床价值显著。

Abstract: Objective: To construct and validate the comprehensive effect of a multidimensional collaborative care program in preventing pulmonary infection and improving overall prognosis in patients with cerebral hemorrhage in the intensive care unit (ICU). Methods: A prospective study was conducted, selecting 64 patients with cerebral hemorrhage admitted to our hospital’s ICU from January 2023 to April 2024. These patients were randomly divided into a control group and an observation group, with 32 cases in each group. The control group received conventional care, while the observation group underwent a multidimensional collaborative care program that integrated risk assessment, structured bundle interventions, systematic quality control, and early rehabilitation promotion. The incidence of pulmonary infection, duration of mechanical ventilation, and ICU length of stay were compared between the two groups. Additionally, the National Institutes of Health Stroke Scale (NIHSS), Activities of Daily Living Scale (ADL), and Short Form-36 Health Survey (SF-36) were used to assess patients’ neurological function, activities of daily living, and quality of life. Results: After intervention, the incidence of pulmonary infection (0% vs. 15.63%) and total complication rate (6.25% vs. 34.38%) in the observation group were significantly lower than those in the control group (P < 0.05). The duration of mechanical ventilation [(7.30 ± 1.25) days vs. (15.10 ± 1.18) days] and ICU length of stay [(16.23 ± 1.25) days vs. (23.10 ± 3.09) days] in the observation group were significantly shorter than those in the control group (P < 0.05). Simultaneously, the NIHSS score in the observation group was significantly lower than that in the control group, while the scores for each dimension of ADL and SF-36 were significantly higher, with statistically significant differences (P < 0.05). Conclusion: The multidimensional collaborative care program can effectively establish a defense line against pulmonary infection through systematic risk management and structured interventions, significantly reducing the risk of infection and synergistically promoting comprehensive improvements in neurological function and quality of life, demonstrating significant clinical value.