肺康复护理结合无创通气对肺尘埃沉着病合并呼吸衰竭康复效果的影响

Effect of lung rehabilitation nursing combined with noninvasive ventilation on the rehabilitation of pneumoconiosis complicated with respiratory failure

目的探讨肺康复护理结合无创通气对肺尘埃沉着病合并呼吸衰竭康复效果的影响。方法选取2019年8月~2020年8月韶关市职业病防治院收治的80例肺尘埃沉着病合并呼吸衰竭患者作为研究对象,采用随机数字表法将其分为研究组(40例)和对照组(40例)。两组均予以止咳、化痰、平喘、抗肺纤维化等药物对症处理,对照组予以无创呼吸机辅助呼吸治疗和常规护理,研究组则在无创通气治疗基础上采用肺康复护理。比较两组的动脉血氧分压(PaO_(2))及二氧化碳分压(PaCO_(2))的改善情况,采用呼吸机和6 min步行能力测试评估两组运动能力以及呼吸肌耐力指标吸气时间分数(Ti/Ttot)、呼吸浅快指数(f/VT)的变化,并运用圣乔治呼吸问卷(SGRQ)调查患者的生活质量变化。结果两组干预前的PaO_(2)及PaCO_(2)比较,差异无统计学意义(P>0.05),两组干预后的PaO_(2)均高于干预前,PaCO_(2)低于干预前,差异有统计学意义(P<0.05),且干预后研究组的PaO_(2)高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。两组干预前的6 min步行距离、Ti/Ttot及f/VT比较,差异无统计学意义(P>0.05)。干预后,两组的6 min步行距离及f/VT均高于干预前,Ti/Ttot低于干预前,差异有统计学意义(P<0.05),研究组的6min步行距离及f/VT均高于对照组,Ti/Ttot低于对照组,差异有统计学意义(P<0.05)。两组干预前的SGRQ评分比较,差异无统计学意义(P>0.05),两组干预后的SGRQ评分低于干预前,差异有统计学意义(P<0.05),且研究组SGRQ评分低于对照组,差异有统计学意义(P<0.05)。结论肺康复护理结合无创通气进行应用,能提高肺尘埃沉着病合并呼吸衰竭患者的康复效果,改善患者的呼吸功能,减轻呼吸困难症状,提升患者运动能力和生活质量。

Objective To explore the effect of pulmonary rehabilitation nursing combined with noninvasive ventilation on the rehabilitation of pneumoconiosis complicated with respiratory failure.Methods A total of 80 patients with pneumoconiosis complicated with respiratory failure in Shaoguan Occupational Disease Prevention and Control Hospital from August 2019 to August 2020 were selected and divided into study group(40 cases)and control group(40 cases)by the random number table method.Both groups were treated with cough relieving,phlegm-reducing,antiasthmatic,anti-pulmonary fibrosis and other drugs.The control group was treated with non-invasive ventilator assisted breathing therapy and routine nursing,while the research group was treated with lung rehabilitation nursing on the basis of non-invasive ventilation treatment.The improvement of arterial partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))in the two groups were compared.The changes of exercise ability,fractional inspiratory time(Ti/Ttot)and shallow rapid-breathing index(f/VT)of respiratory muscle endurance indexes in the two groups were evaluated by ventilator and 6 min walking ability test,and the changes of quality of life were investigated by St.George′s respiratory questionnaire(SGRQ).Results There was no significant difference in PaO_(2) and PaCO_(2) between the two groups before intervention(P>0.05),PaO_(2) in the two groups after intervention were higher than that before intervention,PaCO_(2) in the two groups after intervention was lower than that before intervention,the differences were statistically significant(P<0.05),and PaO_(2) in the research group was higher than that in the control group,PaCO_(2) in the research group was lower than that in the control group,with statistical significance(P<0.05).There was no significant difference in 6 min walking distance,Ti/Ttot and f/VT between the two groups before intervention(P>0.05).After intervention,the 6 min walking distance and f/VT in both groups were higher than those before intervention,while the Ti/Ttot was lower than that before intervention,the differences were statistically significant(P<0.05).The 6 min walking distance and f/VT in the research group were higher than those in the control group,while the Ti/Ttot was lower than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in SGRQ score between the two groups before intervention(P>0.05).The SGRQ score of the two groups after intervention was lower than that before intervention,the difference was statistically significant(P<0.05).The SGRQ score of the study group was lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion The application of pulmonary rehabilitation nursing combined with non-invasive ventilation can improve the rehabilitation effect of patients with pneumoconiosis complicated with respiratory failure,improve the respiratory function of patients,relieve the symptoms of dyspnea,and enhance the exercise ability and quality of life of patients.