护理干预对家庭使用无创呼吸机的影响
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摘要
目的探讨护理干预对家庭使用无创呼吸机的影响。方法按照随机数字表法将104例慢性阻塞性肺疾病稳定期均分为观察组和对照组各52例,对照组患者接受常规出院指导,观察组患者在此基础上接受针对性护理干预,比较两组干预效果。结果观察组患者面罩佩戴、仪器消毒、平台阀使用、更换滤网、报警处理、仪器保养、吸氧时间、呼吸配合、气道湿化、预防压疮等技巧掌握度均明显高于对照组,差异有统计学意义(P<0.05);观察组患者呼吸机使用期间误吸、排痰困难、口咽干燥、胃肠胀气、幽闭恐惧、皮肤损伤、呼吸机相关性肺炎发生率均明显低于对照组,差异有统计学意义(P<0.05);观察组患者6个月复查时生理功能、生理职能、躯体疾病、一般情况、精力、社会功能、精神健康、情感功能评分均明显高于对照组,差异有统计学意义(P<0.05)。结论针对性护理干预能够有效提高患者对呼吸机使用技巧的掌握度,减少并发症发生,提高生活质量,值得临床推荐。
Objective To explore the effect of nursing intervention on family use of non-invasive ventilator. Methods According to random number table,104 patients with stable chronic obstructive pulmonary disease(COPD) were divided into observation group and control group,52 cases in each group.The patients in the control group received routine discharge guidance.The patients in the observation group received targeted nursing intervention on this basis.The intervention effects of the two groups were compared. Results The mastery of facial mask wear,instrument disinfection,platform valve use,replacement filter,alarm processing,instrument maintenance,oxygen inhalation time,breathing coordination,airway humidification and prevention of pressure sores were significantly higher than those in the control group,the difference was statistically significant(P < 0.05).The incidence of mistaken aspiration,sputum exclusion,oropharyngeal dryness,flatulence,claustrophobic fear,skin injury and ventilator-associated pneumonia in the observation group were significantly lower than those in the control group(P < 0.05).The scores of physiological function,physical function,physical disease,general condition,energy,social function,mental health and emotional function of the observation group were significantly higher than those in the control group during the 6 month reexamination(P < 0.05). Conclusion Targeted nursing intervention can effectively improve the patient's mastery of ventilator skills,reduce complications and improve the quality of life,which is worthy of clinical recommendation.
Objective To explore the effect of nursing intervention on family use of non-invasive ventilator. Methods According to random number table,104 patients with stable chronic obstructive pulmonary disease(COPD) were divided into observation group and control group,52 cases in each group.The patients in the control group received routine discharge guidance.The patients in the observation group received targeted nursing intervention on this basis.The intervention effects of the two groups were compared. Results The mastery of facial mask wear,instrument disinfection,platform valve use,replacement filter,alarm processing,instrument maintenance,oxygen inhalation time,breathing coordination,airway humidification and prevention of pressure sores were significantly higher than those in the control group,the difference was statistically significant(P < 0.05).The incidence of mistaken aspiration,sputum exclusion,oropharyngeal dryness,flatulence,claustrophobic fear,skin injury and ventilator-associated pneumonia in the observation group were significantly lower than those in the control group(P < 0.05).The scores of physiological function,physical function,physical disease,general condition,energy,social function,mental health and emotional function of the observation group were significantly higher than those in the control group during the 6 month reexamination(P < 0.05). Conclusion Targeted nursing intervention can effectively improve the patient's mastery of ventilator skills,reduce complications and improve the quality of life,which is worthy of clinical recommendation.
引文
[1]汪晓艳.无创通气治疗AECOPD合并呼吸衰竭的观察和护理[J].吉林医学,2013,34(5):951-952.
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[10]陈云.护理干预对无创通气病人使用Bi PAP呼吸机耐受性的影响[J].全科护理,2011,9(7):620-621.
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[12]夏文艳,范颖,王芳,等.家庭应用Bipap无创呼吸机现状调查分析[J].现代临床护理,2012,11(8):12-14.
[13]张蕊.护理干预对家庭使用无创呼吸机依从性的影响[J].首都食品与医药,2015,22(20):83.
[14]党建桥,马国伟,张建强,等.长期家庭无创呼吸机治疗慢阻肺合并呼吸衰竭不同治疗模式的临床研究[J].河北医药,2014,36(24):3724-3726.
[15]Lamia B,Cuvelier A,Benichou J,et al.A multi-centre randomized controlled trial of domiciliary non-invasive ventilation vs long-term oxygen therapy in survivors of acute hypercapnic respiratory failure due to COPD.Noninvasive ventilation in obstructive lung disease(NIVOLD)study[J].Rev Mal Respir,2012,29(9):1141-1148.
[16]刘海霞,孙德凤,陈玉兰,等.家庭应用无创呼吸机治疗稳定期重度COPD患者的适用性研究[J].临床肺科杂志,2012,17(4):739-740.
[2]袁明伟.连续护理干预对家庭无创正压通气治疗COPD的影响[J].中国临床研究,2015,28(8):1104-1106.
[3]中华医学会呼吸病学会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-266.
[4]常艳.优质护理干预对无创呼吸机治疗肺心病患者临床效果的作用[J].河北医学,2016,36(3):164-166.
[5]夏芝萍.首次使用无创呼吸机患者不适感的原因及其护理干预[J].当代医学,2016,22(2):99-100.
[6]闵新珍.无创正压通气治疗常见并发症的循证护理[J].吉林医学,2011,32(11):2237-2239.
[7]王红梅,李雅静.护理干预对使用无创呼吸机患者治疗依从性的影响[J].中国临床研究,2013,26(8):867-868.
[8]杨小,王阳,李秀君,等.SF-36量表的信度和效度评价[J].解剖科学进展,2009,15(4):383-385.
[9]张红娟,刘丽.综合护理干预对COPD合并Ⅱ型呼吸衰竭患者无创正压通气治疗效果的影响[J].中国现代医生,2013,51(29):100-102.
[10]陈云.护理干预对无创通气病人使用Bi PAP呼吸机耐受性的影响[J].全科护理,2011,9(7):620-621.
[11]薛银平,赵贯金.护理干预对COPD合并呼吸衰竭患者无创呼吸机治疗依从性的影响[J].中国继续医学教育,2016,8(31):210-212.
[12]夏文艳,范颖,王芳,等.家庭应用Bipap无创呼吸机现状调查分析[J].现代临床护理,2012,11(8):12-14.
[13]张蕊.护理干预对家庭使用无创呼吸机依从性的影响[J].首都食品与医药,2015,22(20):83.
[14]党建桥,马国伟,张建强,等.长期家庭无创呼吸机治疗慢阻肺合并呼吸衰竭不同治疗模式的临床研究[J].河北医药,2014,36(24):3724-3726.
[15]Lamia B,Cuvelier A,Benichou J,et al.A multi-centre randomized controlled trial of domiciliary non-invasive ventilation vs long-term oxygen therapy in survivors of acute hypercapnic respiratory failure due to COPD.Noninvasive ventilation in obstructive lung disease(NIVOLD)study[J].Rev Mal Respir,2012,29(9):1141-1148.
[16]刘海霞,孙德凤,陈玉兰,等.家庭应用无创呼吸机治疗稳定期重度COPD患者的适用性研究[J].临床肺科杂志,2012,17(4):739-740.