有效排痰护理管理模式在慢性阻塞性肺疾病急性加重期患者中的应用效果

摘要

目的 分析有效排痰护理管理模式在慢性阻塞性肺疾病急性加重期(AECOPD)患者中的应用效果.方法 选取2015年1月—2017年1月在四川大学华西医院呼吸内科住院治疗的100例AECOPD患者,采用随机数字表法分为对照组与观察组,每组50例.对照组患者给予常规护理,观察组患者采用有效排痰护理管理模式;两组患者均连续干预6个月.比较两组患者负压吸痰率、住院时间,干预前后呼吸频率(RR)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)、第1秒用力呼气容积占预计值的百分比(FEV1％)、6分钟步行距离、COPD评估测试(CAT)评分、呼吸困难严重程度分级标准(MRC)评分及COPD疾病生命质量测量表评分.结果 观察组患者负压吸痰率低于对照组,住院时间短于对照组(P<0.05).干预前两组患者RR、PaO2、PaCO2、SaO2、FEV1/FVC、FEV1％、6分钟步行距离、CAT评分、MRC评分比较,差异无统计学意义(P>0.05);干预后观察组患者RR、PaCO2、CAT评分、MRC评分低于对照组,PaO2、SaO2、FEV1/FVC、FEV1％高于对照组,6分钟步行距离长于对照组(P<0.05).干预前两组患者日常生活活动评分、社会活动评分、抑郁评分、焦虑评分及COPD疾病生命质量测量表总分比较,差异无统计学意义(P>0.05);干预后观察组患者日常生活活动评分、社会活动评分、抑郁评分、焦虑评分及COPD疾病生命质量测量表总分低于对照组(P<0.05).结论 有效排痰护理管理模式在AECOPD患者中的应用效果良好,可有效改善患者临床症状、肺功能,提患者生存质量.%Objective To analyze the application effect of effective sputum excretion nursing management model in patients with AECOPD.Methods From January 2015 to January 2017,a total of 100 patients with AECOPD were selected in the Department of Respiratory Medicine,West China Hospital of Sichuan University,and they were divided into control group and observation group according to random number table,each of 50 cases. Patients in control group received routine nursing care,while patients in observation group received effective sputum excretion nursing management model;both groups continuously intervened for 6 months. Negative pressure sputum suction ratio,hospital stays,RR,PaO2,PaCO2,SaO2, FEV1/FVC,FEV1,6-minute walking distance,CAT score,MRC score and COPD Disease Quality of Life Scale score before and after intervention were compared between the two groups.Results Negative pressure sputum suction ratio in observation group was statistically significantly lower than that in control group,and hospital stays in observation group was statistically significantly shorter than that in control group(P<0.05). No statistically significant differences of RR,PaO2,PaCO2, SaO2,FEV1/FVC,FEV1％,6-minute walking distance,CAT score or MRC score was found between the two groups before intervention(P>0.05);after intervention,RR,PaCO2,CAT score and MRC score in observation group were statistically significantly lower than those in control group,PaO2,SaO2,FEV1/FVC and FEV1％ in observation group were statistically significantly higher than those in control group,and 6-minute walking distance in observation group was statistically significantly longer than that in control group(P<0.05). No statistically significant differences of activities of daily living score,social activity score,depression score,anxiety score or total COPD Disease Quality of Life Scale score was found between the two groups before intervention(P>0.05),while activities of daily living score,social activity score,depression score,anxiety score and total COPD Disease Quality of Life Scale score in observation group were statistically significantly lower than those in control group after intervention(P<0.05).Conclusion Effective sputum excretion nursing management model has good application effect in patients with AECOPD,can effectively relieve the clinical symptoms,improve the pulmonary function and quality of life.