预见性护理在肺周病变合并COPD患者穿刺活检术中的应用价值

目的 探讨预见性护理在超声引导下肺周病变合并COPD患者穿刺活检术中的应用。 方法 选取亳州市人民医院2015年3月—2017年11月收治的84例肺周占位性病变合并COPD患者作为本次研究对象，签署知情同意书后均进行了超声引导下经皮肺穿刺，使用随机数字表将患者分为对照组和试验组，每组各42例，对照组采用常规护理方法，实验组采用预见性护理方法。统计分析2组取材成功率、穿刺成功率、术后并发症发生率以及患者护理满意度调查表结果。 结果 2组均顺利完成活检，实验组共穿刺129针，其中3针取材不满意，取材成功率97.67%，最终病理正确诊断41例，1例诊断不明确，穿刺成功率97.62%，对照组取材成功率和穿刺成功率均为85.71%，均明显低于实验组，差异有统计学意义(P<0.05)；穿刺术后实验组3例出现轻微并发症，并发症发生率7.1%，对照组8例出现并发症，并发症发生率19.0%，对照组明显高于实验组，差异有统计学意义(P<0.05)；在护理满意度方面，实验组护理评分结果为(96.31±3.26)分，对照组护理评分结果为(85.02±4.02)分，实验组患者满意度明显高于对照组，2组差异有统计学意义；2组的病理结果差异无统计学意义(P>0.05)。 结论 超声引导下对肺周病变合并COPD患者进行穿刺活检术，应用预见性护理措施能有效减少并发症，提高穿刺成功率和护理满意度。 

Application value of predictive nursing in puncture biopsy of lung lesions with COPD

Objective To discuss the application of predictive nursing in ultrasound-guided puncture biopsy for patients with peripheral pulmonary disease and COPD. Methods A total of 84 patients with peripheral pulmonary disease and COPD were selected as the research objects from those admitted in Bozhou People's Hospital between March 2015 and November 2017. The patients were given ultrasound-guided puncture biopsy after signing the informed consent. Patients were randomly divided into the control group and the experimental group using random number table, with 42 cases in each group. The control group was given conventional nursing while the experimental group was given predictive nursing. The two groups were analyzed for the success rate of sampling, the success rate of puncture, the incidence of postoperative complication and nursing satisfaction. Results Both of the two groups were successfully completed biopsy. A total of 129 biopsies were performed in the experimental group, where 3 biopsies were unsatisfied, with the success rate of sampling as 97.67%; finally, 41 cases were correctly diagnosed, and 1 case was unclear, with the success rate of puncture as 97.62%. The success rate of sampling and the success rate of puncture were both 85.71%, which were significantly lower than those in the experimental group, with statistically significant difference (P<0.05). After puncture, 3 cases occurred mild complications in the experimental group (the incidence of complication=7.1%), and 8 cases occurred complications in the control group (the incidence of complication=19%). The incidence of complication was obviously higher in the control group than in the experimental group, with statistically significant difference (P<0.05). In terms of nursing satisfaction, the nursing score was 96.31±3.26 points in the experimental group, while 85.02±4.02 in the control group. The satisfaction of patients in the experimental group was significantly higher than that in the control group, and the difference between the two groups was statistically significant. However, there was no significant difference in pathological results between the two groups (P>0.05). Conclusion For patients with peripulmonary lesions combined with COPD, the application of predictive nursing in the ultrasound-guided puncture biopsy can effectively reduce complications and improve the success rate of puncture and nursing satisfaction.