综合护理干预在COPD伴发呼吸衰竭患者行机械通气中的应用

Application of comprehensive nursing intervention in mechanical ventilation in patients with chronic obstructive pulmonary disease complicated with respiratory failure

目的探讨综合护理干预在慢性阻塞性肺疾病伴发呼吸衰竭患者行机械通气中的应用。方法将84例慢性阻塞性肺疾病伴发呼吸衰竭行机械通气患者分为观察组与对照组,各42例。观察组给予综合护理干预,对照组给予常规护理,比较护理24 h后两组患者氧分压、二氧化碳分压、血氧饱和度、机械通气相关指标及住重症监护室时间,比较两组患者的护理满意度。结果护理24 h后观察组氧分压、二氧化碳分压及血氧饱和度水平均显著高于对照组(P<0.01)。观察组再插管率及呼吸机相关性肺炎发生率显著低于对照组(P<0.05或0.01),有创通气时间及住重症监护室时间均显著短于对照组(P<0.05或0.01)。观察组总满意率显著高于对照组(P<0.05)。结论综合护理干预有助于改善慢性阻塞性肺疾病伴发呼吸衰竭患者的血气指标,降低再插管率及呼吸机相关性肺炎发生率,减少有创通气时间,缩短重症监护室治疗时间,提高医护满意度。

Objective To investigate the application of comprehensive nursing intervention in mechanical ventilation in patients with chronic obstructive pulmonary disease complicated with respiratory failure. Methods 84 patients with chronic obstructive pulmonary disease complicated with respiratory failure were divided into observation group and control group,42 cases in each group.The observation group was given comprehensive nursing intervention,and the control group was given routine care.After 24 hours of nurs- ing care,the oxygen partial pressure,carbon dioxide partial pressure,blood oxygen saturation,mechani- cal ventilation related indicators and time of intensive care unit were compared between the two groups. The nursing satisfaction of the two groups of patients was compared.Results After 24 hours of nursing care,the oxygen partial pressure,carbon dioxide partial pressure and blood oxygen saturation level of the observation group were significantly higher than those of the control group (P<0.01).The incidence of reintubation and ventilator-associated pneumonia in the observation group was significantly lower than that in the control group (P<0.05 or 0.01).Invasive ventilation time and ICU time were significantly shorter than those of the control group (P<0.05 or 0.01).The total satisfaction rate of the observation group was significantly higher than that of the control group (P<0.05).Conclusion Comprehensive nursing in- tervention can improve the blood gas index of patients with chronic obstructive pulmonary disease and respiratory failure,reduce the rate of reintubation and ventilator-associated pneumonia,reduce the time of invasive ventilation,shorten the treatment time in intensive care unit,and improve medical satisfaction.