精细化干预治疗措施对慢性阻塞性肺疾病急性加重期患者预后效果研究

Study on prognostic effect of meticulous intervention treatment measures on patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨精细化干预治疗对慢性阻塞性肺疾病急性加重期患者预后的影响。方法选取新疆维吾尔自治区人民医院2018年2-月2019年10月收治的慢性阻塞性肺疾病急性加重期合并吸衰竭患者168例,随机分成对照组与观察组,每组各为84例。对照组患者接受常规干预治疗,观察组患者在常规干预治疗的基础上,配合精细化干预治疗。比较两组患者肺功能、炎性因子水平、并发症出现率、自我护理能力和护理满意度。结果护理前两组患者肺功能指标、血清炎性因子水平和自我护理能力,无统计学意义(均P>0.05)。护理后观察组患者第一秒用力呼气容积/用力肺活量(FEV1/FVC)比、FEV1/预计值比、自我护理能力和满意率显著高于对照组,并发症发生总率、炎性因子[高敏感性C-反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-12]水平显著低于对照组(均P<0.05)。两组患者并发症经后期治疗,均已痊愈。结论精细化干预治疗能显著改善慢性阻塞性肺疾病急性加重期患者的肺功能,降低炎性因子水平,提高护理满意度和自我护理能力,促进患者痊愈。

Objective To analyze the effect of meticulous intervention treatment on lung function and inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with aspiration failure.Methods 168 patients with acute exacerbation of chronic obstructive pulmonary disease combined with suction failure admitted to People's Hospital of Xinjiang Uygur Autonomous Region from February 2018 to October 2019 were selected and randomly divided into control group and observation group by computer,84 patients in each group.Patients in the control group received routine care,and patients in the observation group received refined care.Lung function,serum inflammatory factors,complications,blood gas index,ventilator tolerance and nursing satisfaction were compared between the two groups.Results There was no significant difference in lung function index,Serum inflammatory factor level and respiratory tolerance between the two groups before nursing(P>0.05).Lung function indexes,FEV 1/FVC ratio,FEV1/expected ratio,ventilator tolerance and satisfaction rate of the lwo groups were higher afer nursing than control group(P<0.05),but total rate of complications,inflammatory factors(hs-CRP,TNF-α,IL-6,IL-12)were significantly lower than those in the control group(P<0.05).Complications in two groups of patients were cured after later treatment.Conclusion meticulous intervention treatment can significantly improve lung function,reduce inflammatory factor level,improve nursing satisfaction,enhance ventilator tolerance,and promote patient recovery.