甲状腺功能减退合并阻塞性睡眠呼吸暂停低通气综合征的护理

Nursing care of patients with hypothyroidism and obstructive sleep apnea hypopnea syndrome

目的：研究综合护理干预对甲状腺功能减退合并阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的影响。方法临床纳入我院2014年9月至2015年9月收治的甲状腺功能减退合并OSAHS患者116例，将所有患者按入院先后顺序分为观察组和对照组各58例。对照组在治疗过程中采用常规护理，观察组在上述基础上采用综合护理干预。观察2组患者护理前后心理情况、睡眠呼吸参数情况、临床症状以及家属满意度情况。结果护理后观察组焦虑自评量表（SAS）、抑郁自评量表（SDS）评分为（42.7±4.5）、（48.2±5.4）分，对照组为（51.4±5.2）、（56.3±6.6）分，观察组显著低于对照组，差异有统计学意义（t=9.635、7.234，均P＜0.01)。观察组平均血氧饱和度、夜间最低血氧饱和度、最长呼吸暂停时间为（0.94±0.04）、（0.86±0.04）、（31.4±2.8）s，优于对照组的（0.88±0.06）、（0.78±0.04）、（40.5±6.7）s，差异有统计学意义（t=6.580、11.423、9.544，均P＜0.05）。观察组满意度为96.55%（56/58），显著高于对照组的86.21%（50/58），差异有统计学意义（χ2=6.787，P＜0.01）。结论综合护理干预对甲状腺功能减退合并OSAHS患者效果显著，明显促进临床症状改善，提高患者心理素质，改善患者睡眠呼吸情况，更加符合患者需求，值得临床应用及推广。

Objective To study the effect of comprehensive nursing intervention on patients with hypothyroidism combined with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of 116 patients with hypothyroidism combined with OSAHS in our hospital from September 2014 to September 2015 were enrolled, and all patients were randomly divided into two groups according to the order of admission. Among the 116 patients, 58 patients treated with routine nursing were set as the control group, and the other 58 patients treated with comprehensive nursing intervention were named as the observation group. The mental status the parameters of sleep apnea, the clinical symptoms and the satisfaction of family members of the two groups before and after nursing care were observed. Results After nursing, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the observation group scored 42.7 ± 4.5, 48.2 ± 5.4, which were significantly lower than those of control group, 51.4 ± 5.2, 56.3 ± 6.6(t=9.635, 7.234,all P<0.01).The average oxygen saturation, the lowest oxygen saturation at night, the longest respiratory pause time in the observation group were (0.94 ± 0.04) s,(0.86 ± 0.04) s, (31.4 ± 2.8)s, better than (0.88 ± 0.06) s, (0.78 ± 0.04) s,(40.5 ± 6.7)s in the control group, the difference was statistically significant(t=6.580, 11.423, 9.544,all P<0.05). The satisfaction degree in the observation group was 96.55%(56/58), significantly higher than 86.21%(50/58) of the control group of, the difference was statistically significant(χ2=6.787, P<0.01). Conclusions Comprehensive nursing intervention on the patients with hypothyroidism combined with OSAHS has significant effect. It can significantly improve the clinical symptoms, psychological quality of patients and patient′ s sleep&nbsp;breathing. It meet the needs of patients better and is worthy of clinical application and promotion.