慢性阻塞性肺疾病行机械通气患者撤机困难的原因及护理策略分析

Analysis on the causes of difficulty in weaning patients with chronic obstructive pulmonary disease undergoing mechanical ventilation and nursing strategies

目的对慢性阻塞性肺疾病(COPD)行机械通气患者撤机困难的原因及临床护理策略进行分析与研究。方法以2018年1月至2019年12月作为研究时间,按照随机数字表法分组,将蚌埠医学院第一附属医院80例COPD行机械通气患者等分为对照组、观察组。对照组患者给予常规护理方法,观察组患者在分析撤机困难原因的基础上给予护理干预,比较两组患者机械通气时间、撤机困难发生率以及患者满意度。结果观察组患者入住ICU时间为(4.7±1.0)d、撤机时间为(3.2±0.5)d、住院时间为(8.3±0.6)d、撤机困难率为2.5%,与对照组比较,差异有统计学意义(P<0.05)。观察组患者服务满意度为97.5%(39/40),对照组患者服务满意度为65%(26/40),与两组数据对比,差异有统计学意义(P<0.05)。结论在COPD行机械通气患者治疗过程中,对撤机困难的原因进行分析,能够帮助患者有效撤机,减少ICU入住时间,实现快速撤机,避免患者长时间住院治疗,降低了撤机的难度,使患者护理满意度更高,可推广。

Objective To analyze and research the causes of difficulty in weaning patients with chronic obstructive pulmonary disease(COPD)undergoing mechanical ventilation and the clinical nursing strategies.Methods A total of 80 patients with COPD undergoing mechanical ventilation admitted to the First Affiliated Hospital of Bengbu Medical College from January 2018 to December 2019 were selected and divided into the control group(n=40)and the observation group(n=40)according to the random number table method.Patients in the control group were given conventional nursing methods,while patients in the observation group were given nursing intervention on the basis of analyzing the reasons of difficulty in weaning.Meanwhile,the mechanical ventilation time,incidence of difficulty in weaning and patients’satisfaction were compared between the two groups of patients.Results Patients in the observation group were admitted to ICU for(4.7±1.0)days,weaned after(3.2±0.5)days,hospitalized for(8.3±0.6)days,and the incidence of difficulty of weaning was 2.5%,in which there was statistically significant difference compared with the control group(P<0.05).The patients’satisfaction of service in the observation group was 97.5%(39/40),while that in the control group was 65%(26/40),and the difference compared between the two groups was statistically significant(P<0.05).Conclusion In the treatment process of patients with COPD undergoing mechanical ventilation,the analysis of the causes of difficulty in weaning can help the patients effectively wean,decrease the ICU hospitalization time,realize rapid weaning,avoid patients being hospitalized for a long time,reduce the difficulty of weaning,and make patients’satisfaction of nursing higher and better promoted.