COPD合并呼吸衰竭经鼻高流量氧疗治疗及护理

Treatment and nursing of patients with COPD combined with respiratory failure undergoing high-flow nasal cannula oxygen therapy

目的:探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并呼吸衰竭经鼻高流量氧疗治疗及护理效果,为临床应用提供参考。方法:回顾性分析2018年4月至2019年7月我院经鼻高流量氧疗治疗的COPD合并呼吸衰竭患者127例的诊疗及护理情况。根据护理方式不同,分为研究组(75例)和对照组(52例)。对照组给予常规护理干预,研究组在常规护理基础上开展强化护理干预,分析比较两组患者血气分析指标、肺功能状况、BODE指数评分及生活质量。结果:干预前,两组患者的血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、血氧分压/动脉血二氧化碳分压(PaO2/FiO2)水平相比,差异无统计学意义(P>0.05)。干预后,研究组PaO2、PaO2/FiO2水平明显高于对照组,差异有统计学意义(P<0.05),研究组PaCO2水平明显低于对照组,差异有统计学意义(P<0.05)。干预前,两组患者:每分钟最大通气量(MVV)、一秒用力呼气容积(FEV1)、用力肺活量(FVC)相比,差异无统计学意义(P>0.05)。干预后,研究组MVV,FEV1,FVC值均明显高于对照组,差异有统计学意义(P<0.05)。干预前,两组患者的BODE指数评分和CAT评分相比,差异无统计学意义(P>0.05)。干预后,研究组BODE指数评分和CAT评分均明显低于对照组,差异有统计学意义(P<0.05)。结论:对COPD合并呼吸衰竭经鼻高流量氧疗治疗患者给予强化护理干预可明显改善患者的呼吸状况和肺功能,值得广泛应用。

Objective:To investigate treatment and nursing of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure undergoing high-flow nasal cannula oxygen therapy,which provided reference for clinical application of patients.Methods:The treatment and nursing condition of 127 cases patients with COPD combined with respiratory failure undergoing high-flow nasal cannula oxygen therapy in our hospital were selected from April 2018 to July 2019 were retrospective analyzed.They were divided into study group(75 cases)and control group(52 cases)according to different nursing methods.The control group was given routine nursing intervention,while the study group was given intensive nursing intervention on the basis of routine nursing.The blood gas analysis indexes,lung function status,BODE index score and quality of life of the patients in the two groups were analyzed and compared.Results:Before intervention,there were no significant difference in PaO2,PaCO2 and PaO2/FiO2 between the two groups(P>0.05).After intervention,PaO2 and PaO2/FiO2 in the study group were significantly higher than those in the control group,the differences were statistical significance(P<0.05),and PaCO2 in the study group was significantly lower than those in the control group,the difference was statistical significance(P<0.05).Before intervention,there was no significant difference in MVV,FEV1 and FVC between the two groups(P>0.05).After intervention,MVV,FEV1 and FVC in the study group were significantly higher than those in the control group,with statistically significant differences(P<0.05),the differences were statistical significance(P<0.05).Before intervention,there was no significant difference in BODE index score and CAT score between the two groups(P>0.05).After intervention,BODE index score and CAT score in the study group were significantly lower than those in the control group,the differences were statistical significance(P<0.05).Conclusion:Intensive nursing intervention for patients with COPD combined with respiratory failure undergoing high-flow nasal cannula oxygen therapy can significantly improve their respiratory condition and lung function,and also improve their prognosis and quality of life,which is worthy of extensive application.