基于问题为导向的安全管理对无创呼吸机治疗Ⅱ型呼吸衰竭患者自我管理能力、血气及炎性反应情况的影响  

Effect of problem-oriented safety management on self-management,blood gas and inflammatory response in patients with type 2 respiratory failure treated with non-invasive ventilator

作　　者：李闪闪 王岚[1] 宋欣欣 杨亚旭 Li Shan-shan;Wang Lan;Song Xin-xin;Yang Ya-xu(Respiratory and Critical Care Center,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China)

机构地区：[1]河南科技大学第一附属医院呼吸与危重症医学中心,河南洛阳471000

出　　处：《四川生理科学杂志》2024年第5期954-956,共3页Sichuan Journal of Physiological Sciences

基　　金：2022年年度医疗卫生指导性科技计划项目(编号:2022056Y)。

摘　　要：目的:研究基于问题为导向的安全管理对无创呼吸机治疗Ⅱ型呼吸衰竭患者自我管理能力、血气及炎性反应情况的影响。方法:我院2021年2月至2022年12月期间91例行无创呼吸机治疗Ⅱ型呼吸衰竭患者随机分为对照组和观察组。对照组45例实施常规干预,观察组46例联合以问题为导向的安全教育管理。干预前及干预4 w后,采用血气分析仪检测两组患者血氧分压(Arterial partial pressure of oxygen,PaO_(2))、二氧化碳分压(Partial pressure of carbon dioxide in artery,PaCO_(2))、血氧饱和度(Spot oxygen saturation,SpO_(2))水平;采用酶联免疫吸附法检测白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)及超敏C反应蛋白(Hypersensitive C-reactive protein,hs-CRP)水平;采用自我护理能力(Exercise of Self-Care Agency Scale,ESCA)量表评估两组患者自我管理能力。结果:与干预前相比,两组PaO_(2)、SpO_(2)、健康认知水平、自我责任感、自我管理技能和自我概念评分均升高,IL-6、TNF-α、hs-CRP、PaCO_(2)水平均降低(P<0.05)。其中观察组变化更为显著(P<0.05)。结论:基于问题为导向的安全管理对无创呼吸机治疗Ⅱ型呼吸衰竭患者效果确切,能够改善患者血气水平,降低炎症反应水平,提高自我管理能力。Objective:To study the effects of problem-oriented safety management on self-management ability,blood gas and inflammatory response in patients with type 2 respiratory failure treated with non-invasive ventilator.Methods:From February 2021 to December 2022,91 patients who received non-invasive ventilator treatment for type II respiratory failure in our hospital were randomLy divided into control group and observation group.The control group(45 cases)received routine intervention and the observation group(46 cases)received problem-oriented safety education management.Before intervention and 4 weeks after intervention,blood gas analyzer was used to detect the blood partial pressure of oxygen in both groups.PaO_(2),Partial pressure of carbon dioxide in artery(PaCO_(2)),Spot oxygen saturation(SpO_(2))level;Enzyme-linked immunosorbent assay(ELISA)was used to detect Interleukin-6(IL-6),Tumor necrosis factor-α(TNF-α),and Hypersensitive C-reactive protein(hs-CRP)levels;The Exercise of Self-Care Agency Scale(ESCA)was used to evaluate the self-management ability of patients in both groups.Results:Compared with before intervention,PaO_(2),SpO_(2),health cognition level,self-responsibility,self-management skills and self-concept scores were increased in both groups,while IL-6,TNF-α,hs-CRP and PaCO_(2) levels were decreased(P<0.05).The change of observation group was more significant(P<0.05).Conclusion:Problem-oriented safety management is effective in the treatment of type II respiratory failure patients with non-invasive ventilator,which can improve blood gas level,reduce inflammatory response level and improve self-management ability.

关 键 词：安全教育管理 Ⅱ型呼吸衰竭 自我管理能力 炎症反应 

分 类 号：R563.8[医药卫生—呼吸系统]