COPD并呼吸衰竭序贯机械通气治疗专职护理的作用

SEQUENTIAL MECHANICAL VENTILATION IN THE TREATMENTT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE COMPLICATING RESPIRATORY FAILURE:EFFECT OF FULL-TIME NURSING

目的探讨专职护理在慢性阻塞性肺疾病（COPD）并呼吸衰竭序贯机械通气治疗中的作用。方法序贯机械通气治疗COPD并呼吸衰竭病人127例,分为专职护理组71例和常规护理组56例。专职护理组给予专职护理,常规护理组仅实施常规护理,比较两组病人护理干预后再插管率、呼吸机相关性肺炎（VAP）发生率、有创通气时间、ICU住院时间和机械通气总时间。结果专职护理组VAP发生率、再插管率、有创通气时间、ICU住院时间和机械通气总时间均低于常规护理组,差异有显著性（χ~2=14.766、8.277,t=3.367~4.971,P〈0.05）。结论专职护理能够有效提高COPD并呼吸衰竭序贯机械通气病人通气功能,提高护理质量,减少不良事件的发生。

Objective To assess the effects of full-time nursing on patients undergoing sequential mechanical ventilation（SMV）for chronic obstructive pulmonary disease（COPD）. Methods Employing SMV,127 COPD patients with respiratory failure were treated.Of whom,71 patients received full-time nursing,and 56 patients were given conventional nursing.Reintubation rate,ventilator-related pneumonia（VRP）,time of invasive ventilation,length of ICU stay and total mechanical ventilation time were compared between the two groups after nursing intervention. Results The incidence of VRP and the rate of reintubation were lower,time of invasive ventilation,length of stay in ICU and total time of mechanical ventilation were shorter in the fulltime nursing group versus that in the conventional nursing group（χ~2=14.766,8.277;t=3.367-4.971;P〈0.05）. Conclusion Full-time nursing can effectively improve the ventilation function of patients receive sequential mechanical ventilation treatment for chronic obstructive pulmonary disease complicating respiratory failure,and reduce the occurrence of adverse accidents.