无创正压通气治疗老年呼吸衰竭患者护理干预.docVIP

无创正压通气治疗老年呼吸衰竭患者护理干预 　 作者：锁安云　王建中　江云　徐红 【摘要】 目的：通过对无创正压通气治疗老年呼吸衰竭患者的护理干预，提高无创正压通气（NIPPV）治疗各种急、慢性呼吸衰竭的疗效。方法：对42例老年呼吸衰竭患者在常规药物治疗的同时，采用经鼻/面罩BiPAP无创正压通气的治疗和护理干预。结果：通过对42例呼吸衰竭患者BiPAP无创正压通气的治疗同时及早采取相关的护理对策，使呼吸衰竭治疗疗效得到了提高。结论：虽然NIPPV使用便利装卸快捷，患者舒适易于接受，费用低，可减少有创通气时易发生的并发症。但仍要慎重选择患者。良好的认知教育、正确规范的操作技术 、严密的监护以及有效的防止不良反应措施，保持气道通畅等护理干预也是NIPPV治疗老年呼吸衰竭成功的关键。 【关键词】 无创正压通气 呼吸衰竭 护理干预 　　Nursing Intervention of Respiratory Failure of Elderly Patients with NIPPV 　　Abstract： Objective： To heighten the efficacy of NIPPV on the acute or chronic elderly patients with respiratory failure by nursing intervention. Method： Based on conventional medical therapy, the therapy and nursing intervention of 42 cases of elderly patients with respiratory failure were received non-invasive bi-level positive airway pressure ventilation by nasal/mouth mask.Result： The treatment of respiratory failure has enhanced. through the therapy on RF of 42 cases of elderly patients with NIPPV and early related nursing measures at the same time. Conclusion： Although NIPPV use convenience, loading and unloading quick, expense low, the patients is comfortable and easy to accept, the illness complication which is easy to occur when the therapy of IPPV is used may be reduced. But the patient should be selected prudently. The cognitive good education, the correct and standard operation technique, the strict monitoring and effective measures to prevent adverse reactions, the nursing intervention of the maintenance of airway potency and so on are also the key to success of NIPPV treatment on elderly patients with respiratory failure. 　　Key words： Non-invasive positive pressure ventilation; Respiratory failure; Nursing intervention 　　无创正压通气（NIPPV）治疗呼吸衰竭是临床上常用的治疗方法。它在许多方面优于有创通气。其使用方便，患者痛苦小，舒适乐于接受，院内感染机会少。研究显示NIPPV对部分急、慢性呼吸衰竭的治疗有肯定的治疗效果［1～3］。我院呼吸内科RICU于2002年以来，对42例老年呼吸衰竭患者在常规药物治疗的同时，依据老年患者的呼吸系统疾病的病理生理特点，采用经鼻/面罩BiPAP治疗，取得了较好的疗效。现将护理干预措施报告如下： 　　1 资料与方法 　　1.1 一般资料：本组42例，男 40例，女 2例，年龄61～79 岁（平均62岁）其中COPD合并呼吸衰竭40例，重症哮喘2例，，均 为II型呼衰。