强化心理护理对呼吸道正压通气辅助治疗重症肺炎伴呼吸衰竭患者血气指标及效果的影响

Effect of intensive psychological nursing plus positive airway pressure ventilation on patients with severe pneumonia and respiratory failure

目的探讨给予重症肺炎伴呼吸衰竭患者呼吸道正压通气辅助治疗时强化心理护理的临床价值。方法从2014-01至2016-12入院治疗肺炎伴呼吸衰竭患者中选取150例重症患者,按照随机数字表法分为对照组、观察组,每组75例,对照组给予常规护理,观察组在常规护理的基础上增加强化心理护理干预。观察并记录干预前、后患者血气指标变化情况,评估患者心理状态、依从性,观察患者相关症状改善时间。结果干预后观察组血气指标(PaO_2、PaCO_2、SaO_2)改善程度均显著大于对照组(P <0. 05);观察组干预后SAS、SDS评分显著低于对照组,完全依从性(77. 33%)显著高于对照组(32. 00%),差异有统计学意义(t=30. 070、31. 852,χ~2=31. 097,P <0. 05);观察组患者咳嗽消失、气促缓解及机械通气、住院平均时间均显著短于对照组,差异有统计学意义(t=13. 118、8. 020、5. 113、19. 051,P <0. 05)。结论给予重症肺炎伴呼吸衰竭患者无创通气辅助治疗时配合实施强化心理护理,可使患者血气指标获得更大程度改善,提高总体疗效。

Objective To evaluate the clinical value of intensive psychological nursing for patients with severe pneumonia and respiratory failure treated with positive airway pressure ventilation. Methods Between January 2014 to December 2016,150 patients with severe pneumonia were equally divided into the control group and observation group. During treatment,the patients were given routine nursing and psychological nursing interventions respectively. Changes of blood gas indexes were measured before and after interventions,while patients’ psychological state and compliance were assessed,and the time related symptoms took to improve was observed. Results After interventions,the blood gas indexes( PaO2,PaCO2,SaO2) improved more significantly than those in the control group( P < 0. 05). After interventions,the scores of SAS and SDS in the observation group were significantly lower than those in the control group,but the rate of total compliance( 77. 33%) was significantly higher( 32. 00%)( t = 30. 070,31. 852,χ^2= 31. 097,P <0. 05). The time taken to suppress a cough and to relieve shortness of breath,the duration of mechanical ventilation and average hospital stay in the observation group were significantly shorter than those in the control group( t = 13. 118,8. 020,5. 113,19. 051,P <0. 05). Conclusions When patients with severe pneumonia and respiratory failure and under intensive psychological care are treated with non-invasive ventilation,blood gas indexes can be improved to a great extent,contributing to the overall curative effect.