综合护理干预在雾化吸入治疗慢阻肺伴呼吸衰竭患者中的效果分析

Application effect of comprehensive nursing intervention in atomizing inhalation treatment for patients with chronic obstructive pulmonary disease and respiratory failure

目的分析综合护理干预在雾化吸入治疗慢性阻塞性肺疾病(以下简称慢阻肺)伴呼吸衰竭患者中的应用效果。方法采用回顾性研究,选取2021年10月至2023年9月期间在商丘市第一人民医院接受雾化吸入治疗的96例慢阻肺伴呼吸衰竭患者,按护理方法不同分为参照组与试验组(每组48例)。参照组男20例,女28例,年龄(66.78±9.14)岁,病程(5.06±1.12)年;试验组男18例,女30例,年龄(66.81±9.13)岁,病程(4.95±1.02)年。两组均进行雾化吸入治疗,参照组给予常规护理,试验组给予综合护理干预(包括心理护理、呼吸道护理、体位护理、生活管理以及康复指导),两组患者药物治疗及护理干预均为7 d,随访3个月。比较干预前后两组肺功能、血气分析指标、生活质量、治疗依从性、护理满意度及并发症发生率。采用t检验、χ^(2)检验进行统计分析。结果干预后,试验组用力肺活量为(3.65±0.52)L、第1秒用力呼气量为(2.65±0.32)L、峰值呼气流速为(82.72±6.23)L/min,均高于参照组[(3.21±0.53)L、(2.31±0.42)L、(78.80±5.81)L/min],两组比较差异均有统计学意义(t=4.105、4.461、3.188,均P<0.05);试验组动脉血二氧化碳分压为(50.05±3.52)mmHg(1 mmHg=0.133 kPa),低于参照组的(61.49±4.03)mmHg,试验组动脉血氧分压为(70.05±6.32)mmHg、酸碱度值为7.42±0.33,均高于参照组[(60.01±5.92)mmHg、7.30±0.21],两组比较差异均有统计学意义(t=14.812、8.032、2.125,均P<0.05);试验组治疗依从性100.0%(48/48),护理满意度97.92%(47/48),均高于参照组[89.58%(43/48)、85.42%(41/48)],试验组并发症发生率4.17%(2/48),低于参照组的20.83%(10/48),两组比较差异均有统计学意义(χ^(2)=5.274、4.909、6.095,均P<0.05)。随访3个月,试验组生理功能(80.05±6.52)分、生理职能(81.05±6.32)分、躯体疼痛(82.72±6.23)分、总体健康(81.88±6.02)分、活力(82.76±6.61)分、社会功能(83.70±6.58)分、情感职能(86.91±6.21)分、精神健康(85.05±5.52)分,均高于参照组[(71.10±5.41)分、(72.08±5.22)分、(71.45±5.06)分、(71.45±4.06)分、(73.08±5.01)分、(72.69±5.53)分、(75.65±5.31)分、(76.10±4.41)分],两组比较差异均有统计学意义(t=7.318、7.581、9.728、9.951、8.085、8.874、9.547、8.776,均P<0.05)。结论综合护理干预不仅能够显著改善雾化吸入治疗慢阻肺伴呼吸衰竭患者的肺功能与动脉血气指标,还能够提高患者治疗依从性及生活质量,降低并发症发生风险,提升患者对护理服务工作的满意度。

Objective To analyze the application effect of comprehensive nursing intervention for patients with chronic obstructive pulmonary disease(COPD)and respiratory failure treated by atomizing inhalation.Methods A total of 96 patients with COPD and respiratory failure who received atomization inhalation at Shangqiu First People's Hospital from October 2021 to September 2023 were selected.They were divided into a reference group and an experimental group according to the nursing methods,with 48 cases in each group.There were 20 males and 28 females in the reference group;they were(66.78±9.14)years old;their disease course was(5.06±1.12)years.There were 18 males and 30 females in the experimental group;they were(66.81±9.13)years old;their disease course was(4.95±1.02)years.Both groups took atomization inhalation therapy.The reference group took routine nursing.The experimental group took comprehensive nursing intervention,including psychological nursing,respiratory tract nursing,postural nursing,life management,and rehabilitation guidance.Both groups took drug therapy and nursing intervention for 7 d.Follow-up was 3 months.The lung function,blood gas analysis indicators,and quality of life before and after the intervention,treatment compliance,nursing satisfaction,and incidence rates of complications were compared between the two groups.t and χ^(2) tests were used.Results After the intervention,the forced vital capacity,forced expiratory volume in first second,and peak expiratory flow in the experimental group were higher than those in the reference group[(3.65±0.52)L vs.(3.21±0.53)L,(2.65±0.32)L vs.(2.31±0.42)L,and(82.72±6.23)L/min vs.(78.80±5.81)L/min],with statistical differences(t=4.105,4.461,and 3.188;all P<0.05).After the intervention,arterial blood carbon dioxide partial pressure,arterial blood oxygen pressure,and pH value in the experimental group were better than those in the reference group[(50.05±3.52)mmHg(1 mmHg=0.133 kPa)vs.(61.49±4.03)mmHg,(70.05±6.32)mmHg vs.(60.01±5.92)mmHg,and(7.42±0.33)vs.(7.30±0.21)],with statistical differences(t=14.812,8.032,and 2.125;all P<0.05).The treatment compliance and nursing satisfaction of the experimental group were higher than those of the reference group[100.0%(48/48)vs.89.58%(43/48)and 97.92%(47/48)vs.85.42%(41/48)];the incidence rate of complications in the experimental group was lower than that in the reference group[4.17%(2/48)vs.20.83%(10/48)];there were statistical differences between the two groups(χ^(2)=5.274,4.909,all 6.095;all P<0.05).Follow-up was 3 months,the scores of physiological function,physiological function,physical pain,general health,vitality,social function,emotional function,and mental health in the experimental group were higher than those in the control group(80.05±6.52 vs.71.10±5.41,81.05±6.32 vs.72.08±5.22,82.72±6.23 vs.71.45±5.06,81.88±6.02 vs.71.45±4.06,82.76±6.61 vs.73.08±5.01,83.70±6.58 vs.72.69±5.53,86.91±6.21 vs.75.65±5.31,and 85.05±5.52 vs.76.10±4.41),with statistical differences(t=7.318,7.581,9.728,9.951,8.085,8.874,9.547,and 8.776;all P<0.05).Conclusion In the treatment of patients with COPD and respiratory failure by atomization inhalation,comprehensive nursing intervention can improve their pulmonary function,arterial blood gas indicators,quality of life,treatment compliance,and satisfaction with nursing service,and reduce the risk of complications.