急性左心功能不全患者无创呼吸机应用过程不适原因分析及护理对策

目的:分析无创呼吸机治疗心功能不全患者应用过程中出现不适的原因,寻找相应的护理措施。方法:使用自制"无创呼吸机应用过程不适记录表"对65例应用无创呼吸机患者出现的不适症状进行登记、统计,并进行原因分析,提出合理的护理措施。结果:无创呼吸机治疗心功能不全患者引起不适的原因包括:咽喉部不适25例(38.46%),鼻粱、颊部压痛18例(27.69%),鼻梁、颊部皮肤损伤10例(15.38%),紧张恐惧心理24例(36.92%),呼吸道干燥5例(7.69%),咳痰不畅6例(9.23%),胃肠胀气7例(10.77%),憋气感9例(13.85%),通气模式设置不当2例(3.08%),参数设定不合理4例(6.15%)。结论:无创呼吸机治疗心功能不全患者疗效显著,但可能在应用过程患者出现一些不适,需要医护人员熟练掌握无创呼吸机的临床使用方法。通过有效的沟通,保持呼吸道的通畅、湿润;指导患者在通气期间有效咳嗽、咳痰方法,正确调节通气模式及参数,可提高患者首次使用鼻/面罩通气的协调性,减轻患者的不适感,提高患者使用无创呼吸机的依从性。

The uncomfortable reasons and nursing countermeasure in the course of non-invasive ventilator in acute left ventricular dysfunction patients

Objective：To analyze some uncomfortable reasons during noninvasive ventilator treatment in patients with acute left ventricular dysfunction,and to find the the appropriate care measures.Methods： To record clinical uncomfortable reasons during non-invasive the ventilator treatment with the home-made uncomfortable reasons table during non-invasive ventilator,and to search the care measures in 65 cases with cardiac dysfunction during non-invasive ventilation therapy,and to analyze the reasons and the care measures.Results：The discomfort reasons from non-invasive ventilator treatment including throat discomfort in 25 cases（38.46%）,biliang,cheek tenderness in 18 cases（27.69%）,the bridge of the nose,cheek skin lesions in 10 patients（15.38%）,nervous fear in 24 cases（36.92%）,respiratory dried in five cases（7.69%）,expectoration poor in 6 patients（9.23%）,flatulence（10.77%）,hold breath sense in 9 cases（13.85%）,ventilation mode set improperly in 2 cases（3.08%）,parameter setunreasonable in 4 cases（6.15%）.Conclusion： Non-invasive ventilator treatment for acute heart failure in patients have significant effect,the medical personnel request familiar clinical use skill,the effective communication,maintaining airway patency,moist,guiding patients effective cough and expectoration during ventilation,correctly adjust ventilation modes and parameters set can improve the coordination for the first time in patients with nasal mask ventilation,and reduce the patient＇s discomfort,improve patient compliance of noninvasive ventilator.