无创正压通气治疗COPD合并Ⅱ型呼吸衰竭观察及护理体会.docVIP

无创正压通气治疗COPD合并Ⅱ型呼吸衰竭观察及护理体会 　　【摘要】 目的 探讨无创正压通气治疗COPD合并Ⅱ型呼吸衰竭的疗效及护理。方法 将60例COPD合并Ⅱ型呼吸衰竭患者随机分为观察组合对照组，两组均予常规药物治疗及相应护理，观察组予NIPPV治疗，对照组予吸氧，观察比较两组血气分析变化及住院时间、住院费用、气管插管率。结果 观察组应用NIPPV治疗后血气指标明显改善，平均住院时间缩短，降低住院费用及气管插管率，与对照组比较差异有统计学意义(P0.05)。结论 NIPPV是治疗COPD合并Ⅱ型呼吸衰竭的有效方法，细致护理可减少不良反应发生，提高NIPPV治疗成功率。? 　　【关键词】 无创正压通气；慢性阻塞性肺疾病(COPD)；Ⅱ型呼吸衰竭；护理??Clinical observation and nursing care in the treatment of COPD with type II respiratory failure by non?invasive positive pressure ventilation 　　 　　SU Qing?ling.2cu, Guang zhou 511400, China 　　? 　　【Abstract】 Objective Discuss the nursing method on treatment of COPD with type II respiratory failure by non?invasive positive pressure ventilation.Methods 60 patients of COPD with type II respiratory failure were divided into experiment group and control group randomly.All patients received conventional medical therapy and appropriate nursing,patients of experiment group received NIPPV,but who of control group received oxygen inhale.The blood gas analysis indexes,length and cost of hospitalization,the rate of tracheal intubation were observed and compared between the two groups.Results The obvious improvement was found in blood gas indexes,length of hospitalization was shortened,cost of hospitalization and the rate of tracheal intubation were markedly reduced in study group.There was significant difference in the comparison between the two groups(P0.05).Conclusion NIPPV is one of effective methods in the treatment of patients of COPD with type II respiratory failure.Meticulous nursing care can decreases the incidence of complications and raise the achievement ratio of NIPPV.? 　　【Key words】 　　NIPPV; COPD; Type II respiratory failure; Nursing 　　? 　　 　　慢性阻塞性肺疾病(Chronic obstructive pulmonary disease，COPD)是一种慢性炎症性疾病，严重影响患者生活质量，常因呼吸道感染，气道阻塞加重，呼吸肌疲劳，通气功能恶化发生II型呼吸衰竭导致死亡［1］，发病率及病死率呈上升趋势。无创正压通气(NIPPV)在COPD合并Ⅱ型呼吸衰竭治疗中日益受到重视，合理应用NIPPV可挽救患者生命，避免气管插管和切开，有报道［2］显示NIPPV治疗成功率达80%~85%。但NIPPV过程中常因患者不能配合呼吸机影响疗效，出现诸多不良反应，限制了通气治疗，护理人员在NIPPV期间密切观察和细致护理起到重要作用。