改良口腔护理模式在AECOPD合并呼吸衰竭患者机械通气治疗中的应用

Application of modified oral nursing mode in mechanical ventilation treatment of patients with AECOPD complicated with respiratory failure

目的研究改良口腔护理模式在慢性阻塞性肺疾病急性加重合并呼吸衰竭患者机械通气治疗中的应用效果。方法选择2017年1月~2019年12月我院治疗的符合标准的患者进行研究。将所有患者按照随机数字表法均分为研究组和对照组,每组各50例,对照组给予常规口腔护理,研究组给予改良口腔护理。比较两组患者肺部阴影消散时间、机械通气时间、ICU住院时间、死亡率等指标。比较两组患者护理前、护理第1、3、5天的Beck评分,C反应蛋白(CRP)、降钙素原(PCT)水平及并发症发生率。结果研究组肺部阴影消散时间为(5.73±1.15)d、机械通气时间为(175.12±14.95)h、ICU住院时间为(17.33±4.41)d,均显著低于对照组的(8.35±1.37)d、(188.05±19.76)h、(21.56±5.17)d,差异均有统计学意义(P<0.05)。两组患者死亡率比较,差异无统计学意义(P>0.05)。研究组护理后第3、5天的Beck评分为(5.35±1.08)分、(4.91±1.01)分,均明显低于对照组的(5.86±1.27)分、(5.48±1.14)分,且研究组CRP与PCT水平为(62.36±18.27)mg/L、(0.73±0.16)ng/mL,均明显低于对照组的(80.41±17.09)mg/L、(1.18±0.29)ng/mL,差异均有统计学意义(P<0.05)。研究组并发症总发生率为10.00%,明显低于对照组的32.00%,差异有统计学意义(P<0.05)。结论改良口腔护理模式对慢性阻塞性肺疾病急性加重合并呼吸衰竭患者机械通气患者机械通气治疗干预效果明显优于传统口腔护理。

Objective To study the application effect of modified oral nursing mode in mechanical ventilation treatment of patients with acute exacerbation of chronic obstructive pulmonary disease complicated with respiratory failure.Methods Patients admitted to our hospital from January 2017 to December 2019 who met the standard were selected as research objects.All patients were randomly divided into the study group(n=50)and the control group(n=50).The control group was given routine oral care,while the study group was given modified oral care.The dissipation time of pulmonary shadow,mechanical ventilation time,ICU hospitalization time in intensive care unit and mortality rate were compared between the two groups.Beck score,the levels of Creactiveprotein(CRP),procalcitonin(PCT)and the incidence of complications were compared between the two groups before nursing and on the first,third and fifth day after nursing.Results The disappearance time of pulmonary shadow,mechanical ventilation time and ICU hospitalization time in the study group were significantly lower than those in the control group(5.73±1.15)d vs(8.35±1.37)d,(175.12±14.95)h vs(188.05±19.76)h,(17.33±4.41)d vs(21.56±5.17)d,respectively,and the difference was significant(P<0.05).There was no significant difference in mortality between the two groups(P>0.05).The third and fifth day after nursing,Beck scores were(5.35±1.08)and(4.91±1.01),respectively in the study group,which were significantly lower than those in the control group(5.86±1.27)and(5.48±1.14).The levels of CRP and PCT in the study group were(62.36±18.27)mg/L and(0.73±0.16)ng/mL,respectively,which were significantly lower than(80.41±17.09)mg/L and(1.18±0.29)ng/mL in the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the study group(10.00%)was significantly lower than that in the control group(32.00%),and the difference was statistically significant(P<0.05).Conclusion The intervention effect of modified oral nursing model on mechanical ventilation is obviously better than that of traditional oral nursing in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with respiratory failure.