70例COPD合并肺性脑病患者无创正压通气治疗的护理效果观察

Observation on the Nursing of Non-invasive Positive Pressure Ventilation Treatment for 70 Patients with COPD Complicat- ed with Pulmonary Encephalopathy

目的分析并评价慢性肺部疾病(chronic pulmonary disease,COPD)合并肺性脑病患者进行无创正压通气(non-invasive positive pressure ventilation,NIPPV)治疗的临床护理效果。方法对70例COPD伴肺性脑病病人在常规治疗前提下实施NIPPV治疗,对比分析治疗前后病人的临床症状以及动脉血气指标改变情况。结果 40例病人在6h内意识转清醒,13例在6～12h内意识转清醒,8例在13～24h内意识转清醒。61例病人治疗后动脉血气指标优于治疗前,差异显著(P<0.05),存在统计学意义。9例病人疗效不理想而转为实施有创机械通气。结论采用无创正压通气治疗慢性阻塞性肺疾病合并肺性脑病并采取有效的护理措施,能有效改善症状,改善呼吸衰竭,其疗效确切,提倡在临床上推广。

Objective To analyze and evaluate the clinical nursing effect of non-invasive positive pressure ventilation （NIPPV） treatment for patients with chronic obstruction pulmonary disease （COPD） complicated with pulmonary encephalopathy. Methods 70 patients with COPD complicated with pulmonary encephalopathy received NPPV on the basis of conventional therapy. Patients＇ clinical symptoms and arterial blood gas index changes before and after treatment were compared and analyzed. Results A total of 40 patients regained consciousness in 6 h, 13 cases in 6 - 12 h, 8 cases in 13 - 24 h. Arterial blood gas index of 61 patients improved significantly after treatment （P 〈0.05）. 9 patients turned to invasive mechanical ventilation due to less-than-ideal curative effect. Conclusions Non-invasive positive pressure ventilation treatment combined with effective nursing can significantly reduce respiratory failure, and improve the clinical symptoms of chronic obstructive pulmonary disease complicated with pulmonary encephalopathy. It is worthy of clinical promotion.