集束化护理对慢性阻塞性肺疾病合并呼吸衰竭患者呼吸机依赖发生率的影响  

Effect of Intensive Care on the Incidence of Ventilator Dependence in Patients with Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

作　　者：郝俊萍[1] 张秋洁[1] Hao Junping;Zhang Qiujie(Qili Hospital of Shandong University,Jinan Shandong 250012,China)

机构地区：[1]山东大学齐鲁医院,山东济南250012

出　　处：《齐鲁护理杂志》2019年第9期35-38,共4页Journal of Qilu Nursing

基　　金：2017年山东大学齐鲁医院科研基金-护理项目(编号:2017QLHL07)

摘　　要：目的:探讨集束化护理对慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者机械通气过程中呼吸机依赖发生率的影响。方法:首先,回顾性分析2015年1月～2016年12月呼吸内科重症监护室COPD合并呼吸衰竭行机械通气患者的临床资料,采用Logistic回归分析法筛选出呼吸机依赖的相关危险因素,并以此为依据,研究干预措施的有效性。其次,选取2017年1月～4月收治的COPD合并呼吸衰竭行机械通气患者60例,随机分为观察组和对照组各30例,对照组实施常规护理,观察组常规护理基础上实施集束化护理。比较两组汉密顿焦虑量表(HAMA)评分、呼吸机相关性肺炎(VAP)发生率及呼吸机依赖发生率。结果:Logistic回归分析结果显示,引起呼吸机依赖的相关危险因素包括VAP、人血白蛋白含量低、存在焦虑等。观察组HAMA评分、VAP发生率及呼吸机依赖发生率均低于对照组(P <0. 05)。结论:集束化护理干预能降低COPD合并呼吸衰竭患者VAP发生率,提高患者对机械通气的心理应对能力,减轻了焦虑,从而有效降低了呼吸机依赖发生率。Objective:To explore the effect of intensive care on the incidence of ventilator dependence during mechanical ventilation in patients with COPD complicated with respiratory failure.Methods:The clinical data of patients with COPD combined with respiratory failure who underwent mechanical ventilation in the respiratory intensive care unit from January 2015 to December 2016 were retrospectively analyzed.Logistic regression analysis was used to screen out ventilator-dependent risk factors,and the effectiveness of intervention measures was studied based on this.Then,a total of 60 cases of mechanical ventilation patients with COPD combined with respiratory failure admitted from January to April 2017 were randomly divided into the observation group and the control group with 30 cases each.The control group received routine nursing,and the observation group was given cluster nursing on the basis of routine nursing.The score of Hamilton anxiety scale(HAMA),the rate of ventilator-associated pneumonia(VAP)and the rate of ventilator dependence were compared between the two groups.Results:Logistic regression analysis showed that the risk factors associated with ventilator dependence included VAP,low serum albumin and existential anxiety,et al.The HAMA score,the incidence of VAP and ventilator dependence in the observation group were lower than those in the control group( P <0.05).Conclusion:Intensive nursing intervention can reduce the incidence of VAP in patients with COPD combined with respiratory failure,improve the psychological coping ability of patients with mechanical ventilation,reduce anxiety of patients,and effectively reduce the incidence of ventilator dependence in patients.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 机械通气 呼吸机依赖 集束化护理 

分 类 号：R473.56[医药卫生—护理学]