无创正压通气治疗慢性阻塞性肺疾病急性加重期合并呼吸衰竭患者的医护一体干预效果分析  

Intervention effect of the integrated care in noninvasive positive pressure ventilation for the treatment of AECOPD patients with respiratory failure

作　　者：曾嘉涛[1] 徐治波[1] 沈鹏[1] 杜月君 邓正旭[1] 陈红[1] 石娟[1] 雷玉林[1] 游雯娟 张俊霞[1] ZENG Jia-tao;XU Zhi-bo;SHEN Pen;DENG Zheng-xu;CHEN Hong;SHI Juan;LEI Yu-lin;YOU Wen-juan;ZHANG Jun-xia(The Second Wards,Respiratory Department,Chengdu Second People's Hospital,Chengdu 610017,China)

机构地区：[1]成都市第二人民医院呼吸内科二病区,四川成都610017

出　　处：《实用医院临床杂志》2018年第1期36-39,共4页Practical Journal of Clinical Medicine

基　　金：成都市卫生局科学研究基金资助(编号:20140735)

摘　　要：目的探讨医护一体干预对慢性阻塞性肺疾病急性加重期(acute exacerbation chronic obstructive pulmonary disease,AECOPD)合并呼吸衰竭患者无创正压通气治疗的效果。方法选择2015年9月至2016年4月我院呼吸内科收治的AECOPD合并呼吸衰竭患者86例,采用随机抽样法分为干预组和对照组各43例。两组均给予常规药物加无创正压通气(noninvasive positive pressure ventilation,NIPPV)治疗,干预组在此基础上给予医护一体综合干预,对照组给予常规护理。比较两组治疗24 h、72 h后两组患者血气指标变化及病情转归。结果两组患者在治疗24 h和72 h后,动脉血二氧化碳分压(Pa CO2)较治疗前显著降低(P<0.05),动脉血氧分压(Pa02)和p H显著上升(P<0.05),且干预组改善明显优于对照组(P<0.05);干预组通气时间、住院天数与并发症均较对照组明显减少(P<0.05)。结论有效的医护一体干预提高了NIPPV治疗AECOPD合并呼吸衰竭的临床疗效,减少了患者的创伤及并发症,且缩短病程。Objective To explore the curative effect of the integrated care intervention in acute exacerbation chronic obstructive pulmonary disease(AECOPD)patients with respiratory failure treated with noninvasive positive pressure ventilation.Methods From September 2015 to April 2016,86 AECOPD patients with respiratory failure in our wards for treatment were selected as the research subjects.They were divided into intervention or control group according to the sampling method,43 in each group.The both groups were treated with conventional drugs plus noninvasive positive pressure ventilation(NIPPV).The intervention group received the integrated health care intervention while the control group received conventional care.Blood gas changes and disease outcome were compared at 24 h and 72 h of the treatments between the two groups.Results The arterial carbon dioxide partial pressure(PaCO 2)was decreased(P<0.05)while arterial oxygen partial pressure(PaO 2)and pH were increased(P<0.05)at 24 h and 72 h after treatment in both group when compared to before treatment.The improvement in the intervention group was better than that in the control group(P<0.05).In addition,the length of hospital stay and complications was significantly reduced in the intervention group when compared to the control group(P<0.05).Conclusion Effective integration care interventions can improve the clinical efficacy of NIPPV in the treatment AECOPD with respiratory failure,reduce the trauma and complications and shorten the course as well.

关 键 词：无创正压通气 慢性阻塞性肺疾病急性加重期 呼吸衰竭 医护一体 

分 类 号：R473.5[医药卫生—护理学]