以家庭为中心的连续护理对COPD患者家用无创呼吸机使用效果的影响

摘要

目的 探讨以家庭为中心的连续护理对慢性阻塞性肺病(COPD)患者家用无创呼吸机使用效果的影响.方法 2015年6月至2016年6月选取出院后需行家庭无创呼吸机治疗的120例COPD患者,根据随机数字表将患者分为观察组和对照组,每组60例.对照组出院时接受常规性出院护理,观察组出院时接受以家庭为背景的自我效能干预,干预时间12周,比较2组患者家庭无创呼吸机使用相关知识评分、呼吸机相关并发症及出院6个月后肺功能改善情况.结果 观察组患者在气道湿化、面罩佩戴、仪器消毒、呼吸配合、吸氧时间、机器保养、更换滤网、面部压疮等方面知晓率高于对照组(P＜0.05).观察组呼吸机相关并发症发生率为6.67％低于对照组23.33％,差异有统计学意义(P＜0.05).观察组患者干预后6 min步行试验(6MWT)、第1秒用力呼气量(FEV1)、第1秒用力呼气量占用力肺活量比率(FEV1/FVC)、最大呼气中段平均流速(MMEF)均大于对照组(P＜0.05).结论 以家庭为中心的连续护理可提高COPD家用无创呼吸机使用效果,降低呼吸机相关并发症,从而改善患者肺功能.%Objective To investigate the effects of family-centered continuous nursing on the using effects of household noninvasive ventilator in patients with chronic obstructive pulmonary disease (COPD).Methods A total of 120 patients with COPD who were treated in our hospital from June 2015 to June 2016 and who had to use household noninvasive ventilator after discharge from hospital were enrolled in the study.These patients were divided into observation group (n =60) and control group (n =60) according to the random number table,the patients in control group were treated by routine discharge nursing,however,the patients in observation group were treated by self-efficacy intervention taking family as background for 12 weeks,then the knowledge scores related with noninvasive ventilator using,ventilator-related complications and lung function improvement state on 6 months after dischsrge from hospital were observed and compared between two groups.Results The awareness rates in aspects of airway humidification,wearing of mask,instrument disinfection,breathing coordination,oxygen absorption time,machine maintenance,filter replacement and facial pressure sores in observation group were significantly higher than those in control group (P ＜ 0.05).The incidence of complications related to ventilator was 6.67％ in observation group,which was 23.33％ in control group,there was a significant difference between two groups (P ＜ 0.05).The levels of forced expiratory volume in 1 second (FEV1),the ratio of forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC),maximum mean expiratory flow rate (MMEF) in observation group were significantly higher than those in control group (P ＜ 0.05).Conclusion The family-centered continuous nursing can improve the using effect of household noninvasive ventilator in patients with COPD,which can decrease ventilator-related complications so as to improve pulmonary function of patients.