临床护理路径在重症肺炎合并心衰患者中的应用效果
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摘要
目的探讨临床护理路径在重症肺炎合并心衰护理中的应用效果。方法选取2017年1～12月榆林市星元第四医院收治的98例重症肺炎合并心衰患者为研究对象,采用随机数字表法分为对照组和观察组,每组各49例。对照组实施常规护理干预,观察组实施临床护理路径模式干预,比较两组血气分析指标、体征恢复情况及心理状况变化的干预效果。结果干预前两组心率、PaO2、PaCO2、SAS、SDS评分相比较无明显差异(P>0.05);干预后观察组心率、PaCO2明显低于对照组,PaO2明显高于对照组(P<0.05);观察组干预后退热时间、气促消失时间、心衰消失时间明显短于对照组(P<0.05);观察组护理满意度明显高于对照组(P<0.05);干预后观察组SAS、SDS评分明显低于对照组(P<0.05)。结论临床护理路径模式干预在重症肺炎合并心衰患者中应用效果明显,不仅可有效改善患者血气指标、临床症状,且明显改善患者心理状态,从而提高患者护理满意度。
Objective To explore the application effect of clinical nursing path in the nursing of severe pneumonia with heart failure.Methods 98 patients with severe pneumonia and heart failure admitted to the hospital from January to December 2017 were randomly divided into the control group and the observation group by the random number table method,49 cases in each group.The control group was given routine nursing intervention,while the observation group was given clinical nursing path intervention.The blood gas analysis indicators[heart rate,arterial partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2)],recovery of signs,intervention effects and changes of psychological status[Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)]were compared between the two groups.Results There was no significant difference in heart rate,PaO2,PaCO2,SAS or SDS scores between the two groups before intervention(P>0.05).The heart rate and PaCO2 in the observation group were significantly lower than while PaO2 was significantly higher than that in the control group(P<0.05).After the intervention,the fever clearance time,disappearance time of shortness of breath and heart failure in the observation group were significantly shorter than those in the control group(P<0.05).The nursing satisfaction of observation group was significantly higher than that of the control group(P<0.05).The SAS and SDS scores of the observation group after the intervention were significantly lower than those of the control group(P<0.05).Conclusion The clinical nursing path intervention has obvious effect on patients with severe pneumonia complicated with heart failure.It can effectively improve the blood gas indexes and clinical symptoms of patients and improve the psychological state and nursing satisfaction of patients.
Objective To explore the application effect of clinical nursing path in the nursing of severe pneumonia with heart failure.Methods 98 patients with severe pneumonia and heart failure admitted to the hospital from January to December 2017 were randomly divided into the control group and the observation group by the random number table method,49 cases in each group.The control group was given routine nursing intervention,while the observation group was given clinical nursing path intervention.The blood gas analysis indicators[heart rate,arterial partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2)],recovery of signs,intervention effects and changes of psychological status[Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)]were compared between the two groups.Results There was no significant difference in heart rate,PaO2,PaCO2,SAS or SDS scores between the two groups before intervention(P>0.05).The heart rate and PaCO2 in the observation group were significantly lower than while PaO2 was significantly higher than that in the control group(P<0.05).After the intervention,the fever clearance time,disappearance time of shortness of breath and heart failure in the observation group were significantly shorter than those in the control group(P<0.05).The nursing satisfaction of observation group was significantly higher than that of the control group(P<0.05).The SAS and SDS scores of the observation group after the intervention were significantly lower than those of the control group(P<0.05).Conclusion The clinical nursing path intervention has obvious effect on patients with severe pneumonia complicated with heart failure.It can effectively improve the blood gas indexes and clinical symptoms of patients and improve the psychological state and nursing satisfaction of patients.
引文
[1]兰秋艳,加尔肯·拉斯拜,李军梅.血必净注射液治疗重症肺炎的临床疗效观察[J].实用心脑肺血管病杂志,2016,24(7):101-104.
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[7]张新梅,安丽丽,左艳,等.心力衰竭的诊断与患者的自我管理[J].临床合理用药杂志,2017,10(11):101-102.
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[9]戴悦,张宝泉,李映兰,等.中国老年人睡眠质量与抑郁、焦虑相关性的Meta分析[J].中华护理杂志,2016,51(4):488-493.
[10]邓旭瑶,卓恺明,王静华.帕罗西汀联合阿普唑仑治疗对老年脑卒中合并焦虑抑郁患者抑郁自评量表、汉密尔顿抑郁量表评分的影响[J].中国老年学杂志,2016,36(15):3694-3695.
[11]黄丽华,孙贻霞,年福慧.米力农治疗52例重症肺炎合并心力衰竭婴幼儿的护理体会[J].安徽医学,2016,37(1):104-105.
[12]郭霞,喻昌利,安庆丽,等.老年重症肺炎患者病原学分布及预后危险因素分析[J].广东医学,2016,37(6):873-875.
[13]许天一,吴萍,王爱玲,等.米力农雾化治疗小儿重症肺炎合并心力衰竭的疗效[J].山东大学学报:医学版,2016,54(7):88-90.
[14]宗小敏,王模奎.集束化护理干预措施预防新生儿呼吸机相关肺炎的效果[J].中国感染控制杂志,2016,15(4):266-268.
[15] Li W,An X,Fu M,et al.Emergency treatment and nursing ofchildren with severe pneumonia complicated by heart failure andrespiratory failure:10case reports[J].Experimental &Thera-peutic Medicine,2016,12(4):2145-2149.
[16]杜爱清.优质护理干预在小儿重症肺炎中的护理效果评价[J].中国现代医生,2016,54(16):163-164.
[17]戴春晖.老年患者重症肺炎合并心衰的临床护理急救方法和效果[J].心血管病防治知识(学术版),2017,18(11):59-61.
[18]李芳玲,聂稀枝,邓淼等.临床护理路径在急性呼吸衰竭患者中的应用研究[J].医学临床研究,2017,34(6):1248-1251.
[19]曾涛,江丽洪,陈开容,等.临床护理路径在支气管哮喘患者健康教育中的应用[J].广东医学,2016,37(16):2519-2520.
[20]黄海英,汪小平,王艳菊.氧驱动雾化联合临床护理路径在重症肺炎患儿中的临床效果观察[J].河北医药,2015,37(12):1911-1913.
[21]李娟.临床路径护理对住院大叶性肺炎患儿治疗依从性及临床疗效的影响[J].现代中西医结合杂志,2016,25(14):1583-1585.
[2]黄妮娜,高晓鹏,章玉丹,等.多巴胺联合酚妥拉明治疗小儿重症肺炎合并心衰疗效研究[J].现代生物医学进展,2017,17(12):2302-2305.
[3]廖笑玲,吴亮.儿童重症肺炎支原体肺炎红细胞分布宽度与心肌损害的相关性分析[J].中国全科医学,2017,20(s1):11-14.
[4]周丽,宋霜,王敏杰,等.综合气道护理对重症肺炎患儿治疗及呼吸道感染的影响[J].中华医院感染学杂志,2017,27(22):5251-5254.
[5]常凤静,许艳民,王艳艳.临床护理路径对小儿支气管肺炎住院患者就医成本、疾病知识及护理满意度的影响[J].中国临床研究,2017,30(8):1140-1142.
[6]中国医师协会急诊医师分会.中国急诊重症肺炎临床实践专家共识[J].中国急救医学,2016,36(2):97-107.
[7]张新梅,安丽丽,左艳,等.心力衰竭的诊断与患者的自我管理[J].临床合理用药杂志,2017,10(11):101-102.
[8]刘兴华,刘筱.临床护理路径应用于小儿支气管肺炎的护理效果分析[J].世界中医药,2016,16(06):1682-1683.
[9]戴悦,张宝泉,李映兰,等.中国老年人睡眠质量与抑郁、焦虑相关性的Meta分析[J].中华护理杂志,2016,51(4):488-493.
[10]邓旭瑶,卓恺明,王静华.帕罗西汀联合阿普唑仑治疗对老年脑卒中合并焦虑抑郁患者抑郁自评量表、汉密尔顿抑郁量表评分的影响[J].中国老年学杂志,2016,36(15):3694-3695.
[11]黄丽华,孙贻霞,年福慧.米力农治疗52例重症肺炎合并心力衰竭婴幼儿的护理体会[J].安徽医学,2016,37(1):104-105.
[12]郭霞,喻昌利,安庆丽,等.老年重症肺炎患者病原学分布及预后危险因素分析[J].广东医学,2016,37(6):873-875.
[13]许天一,吴萍,王爱玲,等.米力农雾化治疗小儿重症肺炎合并心力衰竭的疗效[J].山东大学学报:医学版,2016,54(7):88-90.
[14]宗小敏,王模奎.集束化护理干预措施预防新生儿呼吸机相关肺炎的效果[J].中国感染控制杂志,2016,15(4):266-268.
[15] Li W,An X,Fu M,et al.Emergency treatment and nursing ofchildren with severe pneumonia complicated by heart failure andrespiratory failure:10case reports[J].Experimental &Thera-peutic Medicine,2016,12(4):2145-2149.
[16]杜爱清.优质护理干预在小儿重症肺炎中的护理效果评价[J].中国现代医生,2016,54(16):163-164.
[17]戴春晖.老年患者重症肺炎合并心衰的临床护理急救方法和效果[J].心血管病防治知识(学术版),2017,18(11):59-61.
[18]李芳玲,聂稀枝,邓淼等.临床护理路径在急性呼吸衰竭患者中的应用研究[J].医学临床研究,2017,34(6):1248-1251.
[19]曾涛,江丽洪,陈开容,等.临床护理路径在支气管哮喘患者健康教育中的应用[J].广东医学,2016,37(16):2519-2520.
[20]黄海英,汪小平,王艳菊.氧驱动雾化联合临床护理路径在重症肺炎患儿中的临床效果观察[J].河北医药,2015,37(12):1911-1913.
[21]李娟.临床路径护理对住院大叶性肺炎患儿治疗依从性及临床疗效的影响[J].现代中西医结合杂志,2016,25(14):1583-1585.