精细化护理在慢性阻塞性肺疾病急性加重期合并2型呼吸衰竭患者中的应用

目的分析精细化护理对慢性阻塞性肺疾病加重期合并2型呼吸衰竭(简称"呼衰")患者的影响。方法选取2017年1月—2018年5月在浙江医院呼吸科收治的慢性阻塞性肺疾病加重期合并2型呼衰患者110例,按照随机数字表法分为观察组和对照组各55例。对照组患者应用常规护理,观察组患者应用精细化护理干预。比较2组患者临床症状、护理干预前后肺功能、血气指标的变化,并统计2组患者护理期间并发症的发生率。结果护理干预前,2组患者肺功能及血气指标变化差异无统计学意义(均P>0.05);护理干预后,观察组患者临床症状肺部啰音消失时间及憋喘消失时间明显短于对照组(均P<0.05);干预后观察组患者肺功能FEV1、FVC及FEV1/FVC指标明显优于对照组(均P<0.05);观察组患者血气指标p H值、氧分压(Pa O2)、二氧化碳分压(Pa CO2)改善情况均优于对照组(均P<0.05);护理期间2组患者均有不同程度并发症的发生,但观察组患者误吸、吸入性肺炎、口咽不适等发生率均明显低于对照组(均P<0.05)。结论慢性阻塞性肺疾病加重期合并2型呼衰患者应用精细化护理较常规护理更能提高患者肺功能,改善患者血气指标,降低患者并发症发生率,值得临床应用。

Application of intensive care in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with type 2 respiratory failure

Objective To analyze the effects of intensive care on patients with chronic obstructive pulmonary disease complicated with type 2 respiratory failure. Methods A total of 110 patients with chronic obstructive pulmonary disease complicated with type 2 respiratory failure who were admitted to the respiratory department of our hospital from January 2017 to May 2018 were selected. Patients in the control group were given routine nursing care while patients in the observation group were given intensive nursing intervention. The changes of clinical symptoms, lung function and blood gas indexes before and after the nursing intervention of the two groups were compared, and the incidence of complications during the nursing period of the two groups were calculated. Results Before nursing intervention, there was no statistically significant difference in pulmonary function and blood gas indexes between the two groups (all P>0.05). After nursing intervention, patients in the observation group were significantly shorter than those in the control group in terms of the duration of pulmonary murmur disappearance (all P<0.05). After the intervention, the indicators of lung function FEV1, FVC and FEV1/FVC in the observation group were significantly better than those in the control group (all P<0.05). The improvement of blood gas index pH value, oxygen partial pressure (PaO₂), carbon dioxide partial pressure (PaCO₂) in the observation group was superior to the control group (all P<0.05). During the nursing period, patients in the two groups had different degrees of complications, but the incidence of aspiration, aspiration pneumonia and oropharyngeal discomfort in the observation group was significantly lower than that in the control group (all P<0.05). Conclusion The application of intensive care in patients with chronic obstructive pulmonary disease complicated with type 2 respiratory failure can improve the pulmonary function, improve the blood and gas index and reduce the incidence of complications, which is worthy of clinical application.