全程护理干预改善OSAHS患者持续正压通气治疗依从性和睡眠质量的效果分析

Effectiveness analysis of whole process nursing intervention on treatment adherence of continuous positive airway pressure and sleeping quality of OSAHS patients

目的探讨全程护理干预对改善阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者持续气道正压通气(CPAP)治疗依从性的效果。方法 172例OSAHS患者按照随机数字表法分为实验组及对照组,各86例,均接受CPAP治疗。对照组给予常规护理,实验组实施全程护理干预。比较2组治疗依从性和护理满意度,以及干预前后嗜睡程度和睡眠参数改善情况。结果实验组每日、每周CPAP使用时间均显著长于对照组(P<0.05)。实验组依从性好者45例(52.3%),对照组为23例(26.7%),差异有统计学意义(P<0.05)。干预6个月后,实验组Epworth嗜睡量表(ESS)评分和嗜睡程度显著低于对照组(P<0.05)。2组呼吸暂停低通气指数(AHI)、夜间最低动脉血氧饱和度<90%的氧减时间比与治疗前相比显著降低,最低血氧饱和度显著升高(P<0.05),且实验组较对照组改善更为显著,差异有统计学意义(P<0.01)。实验组满意度为81.4%,显著高于对照组的69.8%(P<0.05)。结论全程护理干预能够提高OSAHS患者接受CPAP治疗的依从性,改善患者睡眠质量,值得借鉴。

Objective To investigate the effect of whole process nursing intervention on treat- ment adherence of continuous positive airway pressure （CPAP） and sleeping quality of patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods A total of 172 OSAHS patients un- dergoing CPAP treatment were assigned to the study group （n = 86） and the control group （n = 86） according to the random numbers table method. The control group was given conventional treatment and the study group was applied with whole process nursing intervention. The treatment adherence and satisfaction to nursing were assessed, and sleepiness degree and sleep respiratory parameters before and after intervention were compared between two groups. Results The daily and weekly time of CPAP use were longer in the study than those in the controls （P 〈0.05）. There were 45 （52.3%） and 23 （26.7%） patients with good treatment adherence to CPAP in the study group and the control group re- spectively, with a significant difference （P 〈 0.05 ）. The Epworth sleepiness score （ESS） and sleepi- ness degree were significant lower in the study group than those in the control group 6 months after in- tervention （P 〈 0.05 ）. The apnea hypopnea index（AHI）, the percent of total sleep time below an ar- terial oxyhemoglobin saturation of 90% were decreased, and the lowest arterial oxygen saturation were increased in both of two groups 6 month after intervention （ P 〈 0.05 ）. The study group received a better improvement on sleep respiratory parameters above compared with the controls （P 〈0.01 ）. the overall satisfaction rate was 81.4% in the study group and was 69.8% in the control group, with a significant difference （P 〈 0.05 ）. Conclusion Whole process nursing intervention is effective to im- prove the adherence of CPAP and sleeping quality of OSAHS patients.