重症专职护理小组在序贯机械通气治疗伴呼吸衰竭慢性阻塞性肺疾病患者中的应用及效果

Severe dedicated care team in sequential mechanical ventilation in the treatment of respiratory failure in patients with chronic obstructive pulmonary disease and the effect pianist

目的探讨重症专职护理小组在序贯机械通气治疗伴呼吸衰竭慢性阻塞性肺疾病患者中的应用及效果。方法选择2010年9月~2012年9月在浙江省台州市立医院住院治疗的61例序贯机械通气治疗伴呼吸衰竭慢性阻塞性肺疾病患者为研究对象,根据有无实施重症专职护理将符合本研究纳入标准和排除标准的患者分为A组（27例）和B组（34例）,A组仅给予常规护理模式指导下的护理干预措施,B组患者则给予重症专职护理模式指导下的护理干预措施,比较两组患者再插管率、呼吸机相关性肺炎发生率、有创通气时间、对护理人员提供护理服务方式和态度的满意度。结果 B组患者再插管率（14.71%）、呼吸机相关性肺炎发生率（2.94%）、有创通气时间[（12.05±5.10）d]明显短或少于A组患者,差异有统计学意义（P〈0.05）,B组患者对护理人员提供护理服务方式（11.76%）和态度（14.71%）的满意度明显高于A组,差异有统计学意义（P〈0.05）。结论重症专职护理模式指导下的护理干预措施不但能够明显减少慢性阻塞性肺疾病患者再插管率、呼吸机相关性肺炎发生率、有创通气时间,而且还能够提高患者对护理人员提供护理服务态度和方式的满意度。

Objective To investigate the severe dedicated care team in sequential mechanical ventilation in the treatment of respiratory failure, chronic obstructive pulmonary disease patients and effect. Methods 61 patients with sequential mechanical ventilation in the treatment of chronic obstructive pulmonary disease patients with respiratory failure who were treated in Taizhou Municipal Hospital in Zhejiang Province from September 2010 to September 2012 were chosen as the research object, hospitalized in, they were divided into group A （cases=27） and group B （cases=34） according to the presence or absence of the implementation of severe and exclusion criteria, patients in group A were only received conventional care model under the guidance of nursing interventions, patients in group B were given the severe full-time care model under the guidance of nursing interventions, the reintubation rate, the ventilator-associat- ed pneumonia, the ventilation time and the attitude and way satisfaction of nurses providing the nursing services for patients in two groups were compared. Results Reintubation rate （14.71%）, the ventilator-associated pneumonia （2.94%）, the ventilation time [（12.05±5.10） d] in patients in group B was significantly shorter or less than patients in group A （P 〈 0.05）, the attitude （11.76%） and way （14.71%） satisfaction of nurses providing the nursing services for patients manner and attitude of satisfaction in group B was significantly higher than that in group A, there was a significant difference （P 〈 0.05）. Conclusion Severe full-time care model under the guidance of the nursing interventions can not only be able to significantly reduce patients with chronic obstructive pulmonary disease reintubation rate and respiratory-associated pneumonia incidence of invasive ventilation time, but also can improve the attitude and way＇ satisfaction of nurses providing the nursing services for patients.