精细化护理干预对老年COPD合并呼吸衰竭患者的应用效果研究

Nursing efficacy of elaborate nursing intervention on elderly patients with COPD complicated with respiratory failure

目的研究精细化护理干预在老年慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者中的应用效果。方法老年COPD合并呼吸衰竭患者96例,随机分为对照组和观察组,每组48例。对照组采用常规护理措施,观察组采用精细化护理干预。比较2组治疗效果、护理满意度及护理前后肺功能[第1 s用力呼吸容积(FEV1)、用力肺活量(FVC)和FEV1/FVC]、动脉血气指标[pH值、动脉血氧分压(PO_2)、动脉二氧化碳分压(PCO_2)、血氧饱和度(SaO_2)]、生存质量及负性情绪变化[焦虑自评量表(SAS)、抑郁自评量表(SDS)]。结果观察组总有效率、护理满意度较对照组明显提高(P<0.05)。2组护理前FEV1、FVC、FEV1/FVC、pH、PO_2、PCO_2、SaO_2、生存质量评分、SAS评分、SDS评分比较,差异无统计学意义(P>0.05);2组护理后FEV1、FVC、FEV1/FVC、pH、PO_2、SaO_2、生存质量评分均较护理前明显提高(P<0.05),PCO_2、SAS评分、SDS评分均较护理前明显降低(P<0.05),且观察组FEV1、FVC、FEV1/FVC、pH、PO_2、SaO_2、生存质量评分高于对照组,PCO_2、SAS评分、SDS评分低于对照组(P<0.05)。结论老年COPD合并呼吸衰竭患者采用精细化护理干预不仅能够提高治疗效果,增强肺功能,改善动脉血气指标,还能提高患者生存质量,消除患者负性情绪,值得临床推广。

Objective To investigate the application effects of elaborate nursing intervention on elderly patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods A total of 96 elderly patients with COPD complicated respiratory failure in our hospital from September 2017 to September 2018 were randomly divided into the observation group(n=48)and the control group(n=48).The patients in the control group were given routine nursing interventions during treatment,and the patients in the observation group were treated by elaborate nursing intervention.The therapeutic effects,degree of nursing satisfaction,lung function index before and after nursing intervention[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and FEV1/FVC],arterial blood gas indexes[pH value,arterial partial pressure of oxygen(PO2),arterial partial pressure of carbon dioxide(PCO2),oxyhemoglobin saturation(SaO2)],the quality of life and the changes of negative emotion[self-rating anxiety scale(SAS),self-rating depressed scale(SDS)]were observed and compared between the two groups.Results The total effective rate and nursing satisfaction degree in observation group were significantly higher than those in control group(P<0.05).Before nursing intervention,there were no significant differences in FEV1,FVC,FEV1/FVC,pH,PO2,PCO2,SaO2,the quality of life scores,SAS scores and SDS scores between the two groups(P>0.05).After nursing intervention,the FEV1,FVC,FEV1/FVC,pH,PO2,SaO2,the quality of life scores in both groups were significantly increased,as compared with those before nursing intervention,however,the levels of PCO2,SAS scores and SDS scores were significantly decreased in both groups(P<0.05).Moreover after nursing intervention the FEV1,FVC,FEV1/FVC,pH,PO2,SaO2,the quality of life scores in observation group were significantly higher than those in control group,however the pCO2,SAS scores and SDS scores were significantly lower than those in control group(P<0.05).Conclusion The application of quality nursing intervention in elderly patients with COPD complicated by respiratory failure can not only enhance the clinical curative effects,improve the pulmonary function,blood gas indexes,but also can improve the quality of life,eliminate the negative emotion of patients,therfor,it is worthy of clinical promotion.