护理干预对阻塞性睡眠呼吸暂停低通气综合征患者无创机械通气治疗依从性的效果评价

Evaluation of the effect of nursing intervention on the compliance of non-invasive mechanical ventilation in patients with obstructive sleep apnea hypopnea syndrome

目的探讨以护士为主导的管理模式对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者使用无创机械通气治疗依从性的干预效果。方法选取2019年9月至2020年8月于天津医科大学总医院睡眠中心行多导睡眠图(PSG)监测诊断为重度OSAHS并进行无创机械通气治疗的患者92例,采用随机数字表法分为干预组(45例)和对照组(47例)。干预组在常规治疗和定期复诊的基础上,于患者购买呼吸机1周内开始定期对其电话随访,访问内容采用Duffy设计的标准电话随访手稿,持续6个月;对照组实施常规治疗、定期复诊,不对其进行电话随访,但鼓励患者进行电话咨询。对干预前后两组患者的Epworth嗜睡量表(ESS)评分以及干预后两组患者的无创机械通气使用依从性进行比较。结果干预后两组患者的ESS评分均较干预前有所降低,差异均具有统计学意义(均P<0.001),且干预后干预组患者的ESS评分低于对照组(P<0.001)。干预后干预组无创机械通气使用的依从性优于对照组(P<0.001)。结论以护士为主导并结合电话随访的管理模式可减轻OSAHS患者的嗜睡情况并提高患者无创机械通气治疗的依从性。

Objective To explore the effect of nurse-led management model in adherence of patients with obstructive sleep apnea hypopnea syndrome(OSAHS)who underwent non-invasive mechanical ventilation.Methods 92 patients with severe OSAHS diagnosed by polysomnography(PSG)and treated with non-invasive mechanical ventilation in Tianjin medical university general hospital from September 2019 to August 2020 were enrolled.The patients were divided into intervention group(45 cases)and control group(47 cases)by random number table.Then,basing on routine treatment and subsequent visit,the patients in intervention group received regular telephone follow-up interviews within one week of ventilator purchasing,and the interview was based on a standard telephone follow-up manuscript designed by Duffy and lasted for six months.The patients in control group received routine nursing treatment and regular subsequent visit,and were not followed up by telephone,but were encouraged to have telephone consultation.The Epworth sleepiness scale(ESS)scores of the two groups before and after the intervention and the compliance of non-invasive mechanical ventilation of the two groups after the intervention were compared.Results After the intervention,the ESS scores of the two groups were lower than those before the intervention(P<0.001),and the ESS scores of the intervention group were lower than those of the control group(P<0.001).After the intervention,the compliance of noninvasive mechanical ventilation in the intervention group was better than that in the control group(P<0.001).Conclusions The nurse-led management model in combination with telephone follow-up can improve the sleepiness of patients and the adherence of using non-invasive mechanical.