综合干预对老年COPD合并呼吸衰竭无创机械通气患者排痰效果及肺换气功能的影响

Effect of comprehensive nursing intervention on expectoration effect and pulmonary ventilation function in COPD and respiratory failure patients with noninvasive ventilation

目的 分析综合干预对老年慢性阻塞性肺疾病(COPD)合并呼吸衰竭无创机械通气患者排痰效果及肺换气功能的影响。方法 86例老年COPD合并呼吸衰竭无创机械通气患者,随机分为对照组与研究组,每组43例,2组患者均采取无创呼吸机通气治疗,对照组采取常规干预方法,研究组采取综合干预方法。对比2组患者排痰效果、干预前后肺换气功能指标变化[血氧分压(PaO_(2))、血氧饱和度(SPO_(2))、动脉组氧饱和度(SaO_(2))、二氧化碳分压(PaCO_(2))]及满意度。结果 研究组每日排痰量少于对照组,痰鸣音评分低于对照组,SPO_(2)恢复时间短于对照组,差异均有统计学意义(P<0.05)。干预后,研究组PaO_(2)、SpO_(2)水平及pH值均高于对照组,PaCO_(2)水平低于对照组(P<0.05)。研究组满意度高于对照组,差异有统计学意义(P<0.05)。结论 综合干预对老年COPD合并呼吸衰竭无创机械通气患者,排痰效果好,能够减少对肺换气功能的不良影响,患者满意度高。

Objective To analyze the effect of comprehensive nursing intervention on expectoration effect and pulmonary ventilation function in chronic obstructive pulmonary disease(COPD) and respiratory failure patients with noninvasive ventilation.Methods The elderly COPD and respiratory failure patients with noninvasive ventilation(n=86) were randomized 1∶1 to receive routine nursing(the control group)or comprehensive nursing intervention(the study group).The expectoration effect and pulmonary ventilation function indexes(oxygen partial pressure [PaO_(2)],oxygen saturation [SpO_(2)],blood oxygen saturation [SaO_(2)],partial pressure of carbon dioxide [PaCO_(2)]),and satisfaction were included as comparators.Results The daily sputum volume in the study group was less than that in the control group,the sputum sound score was lower than that in the control group,the recovery time of SpO_(2)was significantly shorter than that in the control group(P<0.05).After the intervention,the PaO_(2),SpO_(2)levels and pH values in the study group were significantly higher than those in the control group,and the PaCO_(2)level was significantly lower than that in the control group(P<0.05).The satisfaction of the study group was significantly higher than that in the control group(P<0.05).Conclusion For COPD and respiratory failure patients with noninvasive ventilation,the comprehensive intervention has a good effect on sputum discharge,can reduce the adverse effects on pulmonary ventilation function,with high satisfaction.