慢性阻塞性肺疾病急性加重期患者无创正压通气治疗依从性分析

摘要

目的 探讨慢性阻塞性肺疾病(COPD)急性加重期患者抵触无创正压通气(NPPV)治疗的原因,为提高治疗依从性、改善治疗效果提供参考.方法 选取本院64例治疗依从性差的患者,统计分析抵触治疗原因,结合文献及临床经验制定干预措施.对患者进行针对性干预.结果 37例患者认为NPPV治疗时候行动不便,这是最主要的抵触原因,其余原因还包括痰量较多、NPPV造成排痰不便、对治疗有恐惧心理、感觉治疗期间面部不适、自觉憋闷等.12例患者有单一的抵触原因,26例患者有两种抵触原因,其余均有两种以上的抵触原因.13例患者认为了解COPD相关知识,大部分患者表示不清楚(34例患者)或者只有部分了解(17例患者);NPPV相关知识大部分患者表示不了解或完全不了解(43例患者).经过干预后有8例患者拒绝治疗,其余患者均完成治疗.结论 行NPPV治疗的COPD急性加重期患者的依从性可从多方面提高,心理支持、健康教育、家人支持均有助于提高患者依从性.%Objective To explore the reasons for incompliance to noninvasive positive pressure ventilation ( NPPV ) a-mong patients in acute exacerbation of chronic obstructive pulmonary disease ( COPD ) . Methods Reasons for poor compliance of COPD patients in acute exacerbation in our hospital were analyzed. Interventions were carried out on these patients based on literature and clinical experience. Results Limited movement was the major reason for poor compliance to NPPV indicated by 37 patients. Other reasons included large amount of sputum and inconvenient expectoration caused by NPPV, fear, facial discomfort and conscious choking during treatment. Twelve patients expressed single reason for poor compliance, 26 patients expressed two reasons, and the rest more than two reasons. Thirteen patients knew COPD related knowledge, most patients said they did not know ( 34 patients ) or only partially knew ( 17 patients ). Most patients said they did not know NPPV related knowledge ( 43 patients ). After the intervention, all except 8 patients completed the treatment. Conclusion Psychological support, health education, and family support could help improve the compliance to NPPV among COPD patients in acute exacerbation.