精细化护理对慢性阻塞性肺疾病急性加重期患者预后效果研究

Study on the Prognostic Effect of Refined Nursing Care on Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的探讨精细化护理对慢性阻塞性肺疾病急性加重期患者预后的影响。方法选取该院2017年1月—2019年6月收治的慢性阻塞性肺疾病急性加重期合并呼吸衰竭患者168例,依据数字随机分为观察组和对照组,各84例。对照组用常规护理方式,观察组在对照组基础上进行精细化护理,对比两组患者肺功能、炎性因子水平、并发症发生率、自我护理能力和护理满意度。结果护理后,观察组第1秒用力呼气量(FEV1)/用力肺活量(FVC)为(59.87±2.20)%,对照组为(56.98±2.21)%,差异有统计学意义(t=8.494,P<0.05);观察组FEV1/预计值比为(70.21±2.20)%,对照组为(62.54±2.21)%,差异有统计学意义(t=22.543,P<0.05);观察组的营养膳食为45.24%,对照组为23.81%,比较差异有统计学意义(χ^(2)=8.532,P=0.003);观察组不良行为为2.38%,对照组为11.91%,差异有统计学意义(χ^(2)=5.744,P=0.017);观察组总并发症发生率为3.57%,对照组为21.43%,差异有统计学意义(χ^(2)=12.245,P<0.001);观察组超敏C反应蛋白(hs-CRP)为(1.04±0.27)ng/L、肿瘤坏死因子α(TNF-α)为(35.74±2.74)ng/L、白细胞介素6(IL-6)为(31.24±3.33)mg/L、白细胞介素12(IL-12)为(32.26±1.27)μg/L,显著低于对照组的(3.54±0.27)ng/L、(60.65±3.26)ng/L、(40.74±3.25)mg/L、(60.36±1.20)μg/L,差异有统计学意义(P<0.05)。结论精细化护理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 explore the impact of refined nursing care on the prognosis of patients with chronic obstructive pulmonary disease in the acute exacerbation stage.Methods A selection of 168 patients with chronic obstructive pulmonary disease in acute exacerbation of chronic obstructive pulmonary disease and aspiration failure admitted to the hospital from January 2017 to June 2019 were randomly divided into observation group and control group,with 84 cases in each group.The control group used conventional nursing methods,and the observation group performed refined nursing on the basis of the control group.The lung function,inflammatory factor levels,complication rate,self-care ability and nursing satisfaction were compared between the two groups.Results After nursing,the observation group's first second forced expiratory volume(FEV1)/forced vital capacity(FVC)was(59.87±2.20)%,and the control group was(56.98±2.21)%,the difference was statistically significant(t=8.494,P<0.05);the ratio of FEV1/expected value in the observation group was(70.21±2.20)%,and in the control group was(62.54±2.21)%,the difference was statistically significant(t=22.543,P<0.05).The nutritional diet of the observation group was 45.24%,and that of the control group was 23.81%,the difference was statistically significant(χ^(2)=8.532,P=0.003);the bad behavior of the observation group was 2.38%,and the control group was 11.91%,the difference was statistically significant(χ^(2)=5.744,P=0.017);the total complication rate in the observation group was 3.57%and that in the control group was 21.43%,the difference was statistically significant(χ^(2)=12.245,P<0.001).In the observation group,the hypersensitivity C-reactive protein(hs-CRP)was(1.04±0.27)ng/L,tumor necrosis factorα(TNF-α)was(35.74±2.74)ng/L,and interleukin 6(IL-6)was(31.24±3.33)mg/L,and interleukin 12(IL-12)was(32.26±1.27)μg/L,which was significantly lower than the control group(3.54±0.27)ng/L and(60.65±3.26)ng/L,(40.74±3.25)mg/L,(60.36±1.20)μg/L,the difference was statistically significant(P<0.05).Conclusion Refined care can significantly improve the lung function of patients with chronic obstructive pulmonary disease in the acute exacerbation stage,reduce the level of inflammatory factors,improve nursing satisfaction and self-care ability,and promote the recovery of patients.