风险评估护理对COPD伴呼吸衰竭行机械通气患者血气指标与预后的影响研究  

Study on the Influence of Risk Assessment Nursing on Blood Gas Index and Prognosis of COPD Patients with Respiratory Failure Undergoing Mechanical Ventilation

作　　者：刘玉华[1] LIU Yu-hua(People's Hospital of Boxing County,Binzhou 256500,China)

机构地区：[1]山东省博兴县人民医院,山东滨州256500

出　　处：《中国医药指南》2020年第21期34-35,40,共3页Guide of China Medicine

摘　　要：目的探讨风险评估护理对COPD伴呼吸衰竭行机械通气患者血气分析指标及预后的影响。方法选取我院(2017年6月至2020年1月)收治的80例COPD-RF患者,均经临床检查确诊,行贯机机械通气治疗,根据不同护理分为两组,对照组(n=40)接受常规护理,观察组(n=40)接受风险评估护理,两组患者均接受常规,包括生命体征监测、环境护理、呼吸机护理、压疮护理、饮食护理等,观察组再接受风险评估护理。对比两组患者护理前后血气分析指标[血氧饱和度(SaO2)、动脉血氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、动脉氢离子浓度(pH)]、心功能指标[左心室射血分数(LVEF)、肺动脉压(PAP)]、肺功能指标[第一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)]和机械通气时间、ICU停留时间、住院时间以及预后情况。结果护理后观察组患者SaO2、PaO2、PaCO2、pH分别为(97.54±5.42)%、(92.44±4.77)mm Hg、(37.75±1.79)mm Hg、(7.65±0.34),护理后对照组患者SaO2、PaO2、PaCO2、pH分别为(88.80±3.07)%、(78.66±5.65)mm Hg、(47.25±1.22)mm Hg、(7.08±0.42),护理后两组患者SaO2、PaO2、PaCO2、pH对比差异明显(t=8.8740、11.7865、27.7365、6.6713,P<0.05)。护理后观察组患者LVEF、PAP、FEV1/FVC、FEV1分别为(65.62±3.29)%、(34.38±1.88)mm Hg、(63.58±3.61)、(63.65±3.58)%,护理后对照组患者LVEF、PAP、FEV1/FVC、FEV1分别为(53.28±2.56)%、(40.15±1.96)mm Hg、(52.23±2.75)、(52.68±2.30)%,护理后两组患者LVEF、PAP、FEV1/FVC、FEV1对比差异明显(t=18.7219、13.4368、15.8179、16.3050,P<0.05)。两组患者机械通气和ICU停留以及住院时间对比差异明显(P<0.05)。观察组并发症发生率和病死率明分别为5.00%(2/40)、2.50%(1/40),显低于对照组20.00%(8/40)、10.00%(4/40),以上数据有统计学差异(χ2=10.2857、4.8000,P<0.05)。结论风险评估护理可有效促进患者心肺功能改善,缩短机械通气时间、ICU停留时间,提高治疗成功率。Objective To explore the effect of risk assessment nursing on blood gas analysis index and prognosis of COPD patients with respiratory failure undergoing mechanical ventilation.Methods 80 COPD-RF patients in our hospital(from June 2017 to January 2020)were diagnosed by clinical examination and treated by mechanical ventilation.According to different nursing,they were divided into two groups:the control group(n=40)received routine nursing,the observation group(n=40)received risk assessment nursing,and both groups received routine nursing,including vital signs monitoring,environmental nursing,ventilator nursing and pressure nursing The observation group received risk assessment nursing again.Blood gas analysis indexes(SaO2,PaO2,PaCO2,pH),cardiac function indexes(LVEF,PAP),pulmonary function indexes(FEV1,FEV1/FVC)and mechanical indexes)were compared before and after nursing between the two groups Ventilation time,ICU stay time,hospitalization time and prognosis.Results SaO2,PaO2,PaCO2 and pH in the observation group were(97.54±5.42)%,(92.44±4.77)mm Hg,(37.75±1.79)mm Hg and(7.65±0.34),respectively.SaO2,PaO2,PaCO2 and pH in the control group were(88.80±3.07)%,(78.66±5.65)mm Hg,(47.25±1.22)mm Hg and(7.08±0.42),respectively Significant(t=8.8740,11.7865,27.7365,6.6713,P<0.05).The LVEF,PAP,FEV1/FVC and FEV1 in the observation group were(65.62±3.29)%,(34.38±1.88)mm Hg,(63.58±3.61)and(63.65±3.58)%,respectively,while those in the control group were(53.28±2.56)%,(40.15±1.96)mm Hg,(52.23±2.75)and(52.68±2.30)%,respectively/There was significant difference between FVC and FEV1(t=18.7219,13.4368,15.8179,16.3050,P<0.05).There were significant differences in mechanical ventilation,ICU stay and hospital stay between the two groups(P<0.05).The morbidity and mortality of the observation group were 5.00%(2/40)and 2.50%(1/40)respectively,which were significantly lower than that of the control group(20.00%(8/40)and 10.00%(4/40).The above data had statistical differences(χ2=10.2857,4.8000,P<0.05).Conclusion Risk assessmen

关 键 词：风险评估 护理 COPD 呼吸衰竭 机械通气 血气分析 

分 类 号：R473.5[医药卫生—护理学]