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目的探讨临床护理路径在氧气雾化给药联合BIPAP呼吸机治疗慢性阻塞性肺疾病(COPD)并发Ⅱ型呼吸衰竭患者中的应用效果。方法选取茂县人民医院2014年4月—2015年4月收治的COPD并发Ⅱ型呼吸衰竭患者80例,随机分为对照组和试验组,各40例,患者入院后均给予氧气雾化给药联合BIPAP呼吸机治疗,对照组患者给予常规护理干预,试验组患者采用临床护理路径。比较两组患者治疗前后血气分析指标[动脉血二氧化碳分压(PaCO_2)、动脉血氧分压(PaO_2)与血氧饱和度(SaO_2)]、6 min步行距离、呼吸困难量表(mMRC)评分、生活质量量表(QOL)评分。结果治疗前,两组患者PaCO_2、Pa O2与Sa O2水平比较,差异无统计学意义(P>0.05);治疗后,试验组患者PaCO_2水平低于对照组,Pa O2、Sa O2水平高于对照组(P<0.05)。治疗前,两组患者6 min步行距离与m MRC评分比较,差异无统计学意义(P>0.05);治疗后,试验组患者6 min步行距离长于对照组,m MRC评分低于对照组(P<0.05)。治疗前,两组患者日常生活能力评分、社会活动状况评分、抑郁心理症状评分与焦虑心理症状评分比较,差异无统计学意义(P>0.05);治疗后,试验组患者日常生活能力评分、社会活动状况评分、抑郁心理症状评分与焦虑心理症状评分低于对照组(P<0.05)。结论临床护理路径在经氧气雾化给药联合BIPAP呼吸机治疗COPD并发Ⅱ型呼吸衰竭中的临床辅助治疗效果明显,可有效调节患者血气分析指标,改善其活动耐力与呼吸困难程度,提高生活质量。
Objective To explore the clinical effect of clinical nursing in the treatment of chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure by oxygen atomization combined with BIPAP ventilator. Methods Eighty patients with COPD complicated with type Ⅱ respiratory failure who were treated in Mao County People’s Hospital from April 2014 to April 2015 were randomly divided into control group and experimental group, 40 patients in each group. All patients were given oxygen aerosolized combination BIPAP ventilator therapy, control group of patients given routine nursing intervention, test group of patients with clinical nursing path. Blood gas analysis indexes (PaCO 2, PaO 2 and SaO 2), walking distance 6 min, and mMRC scores before and after treatment were compared between the two groups , Quality of life scale (QOL) score. Results Before treatment, there was no significant difference in the PaCO_2, PaO 2 and SaO 2 levels between the two groups (P> 0.05). After treatment, the PaCO_2 level in the experimental group was lower than that in the control group, and Pa O2 and Sa O2 levels were higher than those in the control Group (P <0.05). Before treatment, there was no significant difference between the two groups in walking distance and m-MRC score at 6 min (P> 0.05). After treatment, the walking distance of patients in test group was longer than that of control group at 6 min, and the m-MRC score was lower than that of control group <0.05). Before treatment, there was no significant difference between the two groups in daily living ability score, social activity score, depression symptom score and anxiety psychological symptom score (P> 0.05). After treatment, the scores of daily living ability, The activity score, depression symptom score and anxiety symptom score were lower than those in the control group (P <0.05). Conclusion Clinical nursing pathways in the clinical adjuvant treatment of COPD complicated with type Ⅱ respiratory failure by oxygen atomization combined with BIPAP ventilator have obvious effect, which can effectively adjust blood gas analysis index, improve endurance and dyspnea and improve quality of life .