护理干预对无创正压通气治疗 COPD 合并呼吸衰竭效果的影响

Effect of nursing intervention on the efficacy of noninvasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease combined with respiratory failure

目的：探讨护理干预应用于无创正压通气治疗COPD合并呼吸衰竭的临床疗效。方法将COPD合并呼吸衰竭患者80例按照随机数字表法随机分为观察组和对照组，每组各40例。两组均给予无创正压通气治疗，对照组采用常规护理，观察组给予心理护理、呼吸道护理、并发症护理等专门护理，比较两组治疗效果。结果无创正压通气治疗7 d 后观察组患者pH 值为（7．4±0．1），PaO2为（72．5±7．0） mmHg，＆amp;nbsp；PaCO2为（40．0±6．0）mmHg，呼吸频率为（16．0±4．0）次/min，心率为（86．0±8．0）次/min，分别优于对照组的（7．3±0．1），（58．7±6．2）mmHg，（48．7±6．5）mmHg，（19．0±5．0）次/min，（93．0±9.0）次/min，差异均有统计学意义（ t值分别为2．19，2．68，2．41，2．38，2．49；P＜0．05）。观察组治疗有效率为95．0％（38/40），对照组为80．0％（32/40），两组比较差异有统计学意义（χ2＝4．11， P ＜0．05）。结论对COPD合并呼吸衰竭患者采用无创正压通气治疗期间给予有效的护理干预，可提高临床疗效，改善患者的预后质量。

Objective To explore the clinical efficacy of nursing intervention on noninvasive positive pressure ventilation （ NPPV） in the treatment of chronic obstructive pulmonary disease （ COPD） combined with respiratory failure .Methods Eighty patients with COPD combined with respiratory failure from April 2012 to April 2013 were divided into the control group and the observation group according to the random number table , each with 40 cases.All patients received the NPPV , and the control group received the routine nursing , and the observation group received the special nursing including psychological nursing , respiratory tract nursing , complication nursing.The clinical efficacy was compared between two groups .Results The pH value, arterial partial pressure of oxygen （ PaO2 ） , partial pressure of carbon dioxide （ PaCO2 ） , respiratory rate , heart rate （ HR） were （7.4 ±0.1）, （72.5 ±7.0） mmHg, （40.0 ±6.0） mmHg, （16.0 ±4.0） /min, （86.0 ±8.0） beats/min in the observation group seven days after NPPV , which were better than （7.3 ±0.1）, （58.7 ±6.2） mmHg, （48.7 ±6.5） mmHg, （19.0 ±5.0） /min, （93.0 ±9.0） beats/min in the control group, and the differences were statistically significant （t=2.19,2.68,2.41,2.38,2.49, respectively;P〈0.05）.The effective rate of treatment was 95.0%（38/40） in the observation group, and was 80.0% （32/40） in the control group, and the difference was statistically significant （χ2 =4.11, P 〈0.05 ）.Conclusions The effective nursing intervention on NPPV in the treatment of COPD combined with respiratory failure can increase the clinical efficacy, and improve the prognosis quality of patients .