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目的观察综合护理干预在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者中的应用效果。方法选取南阳市中心医院2014年2月—2016年3月收治的64例慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者,随机分为对照组和研究组,各32例。对照组患者予以常规护理(包括气道护理、心理护理、饮食护理、导管护理、呼吸机面罩护理等);研究组在对照组基础上予以综合护理干预(包括:入院指导、气管插管护理、体位护理、吸痰护理、心理护理等)。两组患者均干预并随访3个月。观察统计两组患者临床症状情况、治疗前后血气指标、肺功能指标。采用SPSS16.0统计软件进行统计分析,计量资料用均数±标准差(±s)表示,采用t检验,计数资料用率(%)表示,采用χ2检验,P<0.05表示差异有统计学意义。结果研究组体温恢复时间(2.3±1.6)d、肺部啰音消失时间(7.0±2.0)d、喘憋消失时间(5.2±1.9)d及住院时间(9.2±2.2)d均少于对照组(4.6±2.0)、(9.3±3.5)、(8.1±2.3)、(12.5±3.0)d,差异均有统计学意义(P<0.05);干预前,两组动脉血氧分压和动脉血二氧化碳分压差异均无统计学意义(P>0.05);干预后,研究组动脉血氧分压(87.8±7.8)mm Hg高于对照组(64.0±7.7)mm Hg,动脉血二氧化碳分压(52.3±7.6)mm Hg低于对照组(68.9±5.9)mm Hg,差异均有统计学意义(P<0.05);干预后,研究组肺功能指标改善幅度优于对照组,差异有统计学意义(P<0.05)。结论对慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者予以综合护理干预,可有效缩短患者临床症状恢复时间及住院时间,显著改善其血气指标及肺功能。
Objective To observe the effect of comprehensive nursing intervention in patients with chronic obstructive pulmonary disease and type Ⅱ respiratory failure. Methods Sixty-four patients with chronic obstructive pulmonary disease and type Ⅱ respiratory failure admitted to Nanyang Central Hospital from February 2014 to March 2016 were randomly divided into control group and study group, with 32 cases in each group. The patients in the control group were given routine nursing care (including airway care, psychological care, dietary nursing, catheterization and ventilator mask care). The study group was given comprehensive nursing intervention (including admission guidance, endotracheal intubation care, Body care, suction nursing, psychological care, etc.). Both groups were intervened and followed up for 3 months. Clinical symptoms and signs of the two groups were observed, blood gas indexes before and after treatment, lung function indexes. Statistical analysis was performed using SPSS16.0 statistical software. The measurement data were expressed as mean ± standard deviation (± s), t test was used, and the data usage rate (%) was expressed as a percentage. Statistical analysis was performed using χ2 test. P <0.05 was considered statistically significant significance. Results The body temperature recovery time (2.3 ± 1.6) days, pulmonary rales disappearance time (7.0 ± 2.0) days, asthma extinction time (5.2 ± 1.9 days) and hospital stay (9.2 ± 2.2 days) were less in the study group than in the control group (4.6 ± 2.0), (9.3 ± 3.5), (8.1 ± 2.3) and (12.5 ± 3.0) d, respectively. There were significant differences between the two groups (P <0.05) (P> 0.05). After intervention, the arterial partial pressure of oxygen (87.8 ± 7.8) mm Hg in the study group was significantly higher than that of the control group (64.0 ± 7.7) mm Hg, the partial pressure of arterial carbon dioxide 52.3 ± 7.6) mm Hg was lower than that of the control group (68.9 ± 5.9) mm Hg, the difference was statistically significant (P <0.05); after intervention, the study group had better improvement of pulmonary function indexes than the control group, the difference was statistically significant (P <0.05). Conclusion Comprehensive nursing intervention for patients with chronic obstructive pulmonary disease and type Ⅱ respiratory failure can effectively shorten the recovery time and hospitalization time of patients with clinical symptoms, and significantly improve their blood gas indexes and pulmonary function.