无创通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床观察及护理

Clinical observation and nursing of noninvasive ventilation in the treatment of chro-nic obstructive pulmonary disease combined with respiratory failure

目的 探讨无创通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床观察及护理. 方法 选择2014年1月至2015年3月被我院确诊为慢性阻塞性肺疾病合并呼吸衰竭的患者152 例,随机分为治疗组（ 78例）和对照组（74例） ,对照组采用常规治疗,治疗组采用无创通气治疗,比较两组治疗前后血气分析、临床治疗情况以及呼吸频率和心率等情况. 结果 治疗前,两组血气分析指标、呼吸频率及心率无明显差异,治疗后,两组差异有统计学意义（P〈0. 05）;对照组治疗前后pH无显著变化,而PaO2、PaCO2 与治疗前相比,有明显差异;治疗组治疗后血气分析指标与治疗前相比,差异显著. 两组患者在并发症发生率、治疗时间、有效率方面差异有统计学意义. 结论 采用无创通气治疗慢性阻塞性肺疾病合并呼吸衰竭能够有效缓解患者的临床症状,使患者血气分析指标以及生活质量得以改善,是安全、理想、可靠的治疗手段,在临床上有着广泛的应用前景.

Objective To explore the clinical observation and nursing of noninvasive ventilation in the treat-ment for chronic obstructive pulmonary disease combined with respiratory failure. Methods A total of 152 cases of pa-tients diagnosed with chronic obstructive pulmonary disease combined with respiratory failure in our hospital from January 2014 to March 2015 were randomly divided into treatment group and control group, with 74 cases in each group. Patients of control group were given conventional treatment, and those of observation group were given noninvasive ventila-tion. And blood gas analysis before and after the treatment, clinical treatment and respiratory frequency and heart rate of patients were compared between two groups. Results There was no obvious difference between two groups in index of blood gas analysis, respiratory frequency and heart rate before treatment. The differences between the two groups were statistically significant after treatment （ P〈0. 05 ） . The control group had no significant change in pH before and after treatment. While compared with pre-treatment, PaO2 and PaCO2 of the control group changed a lot. There was signifi-cantly difference between before and after the treatment in patients of observation group in index of blood gas analy-sis. Statistical significance was shown on the incidence of complications, duration of treatment, efficiency between two groups. Conclusion The introduction of noninvasive ventilation in treating chronic obstructive pulmonary disease com-bined with respiratory failure can effectively relieve clinical symptoms, and improve the index of blood gas analysis and quality of life in patients. The treatment method is safe, ideal and reliable, so that it has a broad prospect.