无缝隙管理模式对重症急性呼吸窘迫综合征患者的应用价值

Application value of seamless nursing model in patients with severe acute respiratory distress syndrome

目的研究无缝隙管理模式在重症急性呼吸窘迫综合征(ARDS)患者中的应用价值。方法选取2019年1月至2020年12月收治的重症ARDS患者72例,随机分为对照组和观察组,每组36例。对照组实施常规护理干预,观察组实施无缝隙护理模式干预。观察2组血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC]、炎性因子[C-反应蛋白(CRP)、降钙素原(PCT)]、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分)、Murray肺损伤评分、心理状态、机械通气时间、发热时间、住ICU时间、并发症发生情况及护理满意度。结果2组干预前PaO_(2)、PaCO_(2)、FVC、FEV1、FEV1/FVC、CRP、PCT、APACHEⅡ评分、Murray肺损伤评分、HAMA评分、HAMD评分比较差异无统计学意义(P>0.05);2组干预后PaO_(2)、FVC、FEV1、FEV1/FVC较干预前显著提高,PaCO_(2)、CRP、PCT、APACHEⅡ评分、Murray肺损伤评分、HAMA评分、HAMD评分较干预前显著降低(P<0.05),且观察组PaO_(2)、FVC、FEV1、FEV1/FVC高于对照组,PaCO_(2)、CRP、PCT、APACHEⅡ评分、Murray肺损伤评分、HAMA评分、HAMD评分低于对照组(P<0.05)。观察组机械通气时间、发热时间、住ICU时间较对照组显著缩短,并发症发生率较对照组显著降低,护理满意度较对照组显著提高,差异有统计学意义(P<0.05)。结论对重症ARDS患者实施无缝隙护理模式干预能够有效改善血气分析指标和肺功能,抑制炎性反应,缓解焦虑、抑郁情绪,降低并发症发生率,值得临床推广。

Objective To investigate the application value of seamless nursing model in patients with severe acute respiratory distress syndrome(ARDS).Methods A total of 72 patients with severe ARDS who were treated in our hospital from Jan 2019 to Dec 2020 were enrolled in the study,who were randomly divided into control group and observation group,with 36 cases in each group.The patients in control group were treated by routine care interventions,however,the patients in observation group were treated by seamless nursing nursing intervention.The blood gas analysis indexes(PaO_(2) and PaCO_(2)),lung function(FVC,FEV1 and FEV1/FVC),inflammatory cytokines(CRP and PCT),APACHEⅡscores,Murray lung injury scores,mental state,mechanical ventilation time,fever time,ICU stay time,complications and the nursing satisfaction degree were observed and compared between the two groups.Results Before nursing,there were no significant differences in PaO_(2),PaCO_(2),FVC,FEV1,FEV1/FVC,CRP,PCT,APACHEⅡscores,Murray lung injury scores,HAMA scores and HAMD scores between the two groups(P>0.05).After nursing the levels of PaO_(2),FVC,FEV1 and FEV1/FVC in both groups were significantly increased,however,the levels of PaCO_(2),CRP,PCT,APACHEⅡscores,Murray lung injury scores,HAMA scores and HAMD scores were significantly decreased(P<0.05).Moreover the increase degree and decrease degree in observation group were more significant than those in control group(P<0.05).In addition the mechanical ventilation time,fever time and ICU stay time in observation group were significantly shorter than those in control group(P<0.05).The incidence rate of complications in observation group was significantly lower than that in control group,and the nursing satisfaction degree in observation group was significantly higher than that in control group(P<0.05).Conclusion The seamless nursing intervention for patients with severe ARDS can effectively improve the blood gas analysis indexes and lung function,inhibit inflammatory reaction,improve negative emotion,and decrease the incidence of complications,which is worthy of clinical promotion.