NIPPV治疗AECOPD合并重度高碳酸血症呼吸衰竭患者的临床护理

Clinical nursing of respiratory failure patients with severe hypercapnic complicated with AECOPD treated by NIPPV

目的探讨无创正压通气(NIPPV)治疗慢性阻塞性肺疾病急性发作期(AECOPD)合并重度高碳酸血症呼吸衰竭患者的临床护理措施和效果。方法选取本院49例AECOPD合并重度高碳酸血症呼吸衰竭患者,行NIPPV治疗和临床护理,比较治疗前后血气指标和不良反应发生率。结果治疗后的p(O2)、p H显著高于治疗前,而p(CO2)低于治疗前,差异有统计学意义(P<0.05);本组无呼吸道分泌物潴留等严重不良反应出现,3例出现鼻面部压迫性损伤,9例出现胃肠胀气,4例出现咽部不适,不良反应总发生率32.7%。结论 NIPPV能显著改善AECOPD合并重度高碳酸血症呼吸衰竭患者的通气功能,通过精心全面的临床护理能有效减少不良反应发生率,尤其是杜绝严重不良反应的发生。

Objective To investigate clinical nursing measures and effect of respiratory fail- ure patients with severe hypercapnic complicated with acute exacerbation of chronic obstructive pul- monary disease （AECOPD） treated by noninvasive positive pressure ventilation （NIPPV）. Methods A total of 49 respiratory failure patients with severe hypereapnic complicated with AECOPD treated by NIPPV and clinical nursing, the blood gas indexes and the incidence of adverse reaction before and after treatment were compared. Results After treatment, p （ 02 ） and pH was significantly higher than treatment before, while p （CO2 ） was significantly lower than treatment before, the differences were statistically significant（P 〈 0.05 ）. There were no serious adverse reactions such as respiratory tract secretion retention, there were 3 cases with nasal constriction injury, 9 cases with flatulence, 4 cases with pharyngeal discomfort, and the total adverse reaction rate was 32.7%. Conclusion NIP- PV can significantly improve the ventilation function of respiratory failure patients with AECOPD and severe hypercapnic. And careful clinical nursing can effectively reduce the incidence of adverse reactions.