护理干预对睡眠呼吸暂停综合征患者家庭无创通气治疗依从性的影响

目的 探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者家庭无创正压通气（CPAP）治疗依从性及护理干预效果.方法 将睡眠呼吸暂停综合征260例随机分为干预组和对照组,每组各130例,两组均实施鼻持续气道无创正压通气治疗.但干预组在无创通气的同时,采取电话、网络及当面教育等形式进行院外护理指导;对照组采取一般性口头常规护理教育.比较两组在呼吸机使用、治疗前后睡眠结构、呼吸、血氧饱和度、微觉醒等变化情况.结果 随访发现,干预组有125例（96.2％）坚持家庭无创通气治疗,3例（2.3％）因嫌弃麻烦或怕对呼吸机产生依赖而中断治疗,2例（1.5％）因压力滴定不适应无创通气而放弃;对照组90例（69.2％）坚持无创通气治疗,22例（17.0％）嫌弃麻烦而中断治疗,18例（13.8％）完全放弃.两组比较显示干预组各项指标较对照组明显好转,患者睡眠结构趋于正常,且在鼾声评级、呼吸紊乱指数、微觉醒、漏气量等评分中明显低于对照组（P＜0.05）.结论 无创通气疗效和患者依从性密切相关,因此对OSAHS患者应用CPAP治疗时进行综合护理干预,可明显改善呼吸状态,有效提高患者CPAP治疗依从性及生活质量.

Effects of nursing intervention on treatment compliance of patients with obstructive sleep apnea-hypopnea syndrome by continuous positive airway pressure therapy

Objective To investigate the effects of treatment compliance and nursing intervention with continuous positive airway pressure （CPAP） therapy in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）.Methods 260 patients were randomly divided into two groups,both groups were implemented with CPAP treatment,but intervention group was added with out-of-hospital comprehensive care guide by ways of phone contact,internet and in person,control group took oral conventional general education.Results The follow-up showed intervention group had 125 cases of adherence to treatment,3 cases with interruption of treatment,two cases gave up; control group had 90 cases of adherence to treatment,22 cases of interruption of treatment,18 cases of complete giving up.Compared with control group,the intervention group＇ s all indicators improved significantly,patients tended to be normal sleep architecture,and snoring rating,respiratory disturbance index,arousal,such as average air leakage rates were significantly lower than those of control group.Conclusion Application of CPAP therapy in patients with OSAHS comprehensive nursing intervention can significantly improve patients＇ respiratory status,effectively improve CPAP treatment compliance.