摘要
目的 探讨医护一体化工作模式对提高双水平气道内正压（BiPAP）呼吸机辅助通气患者的治疗依从性及效果。方法 将2012年6月~2014年6月在浙江省嘉兴市第一医院呼吸科接受BiPAP呼吸机辅助通气治疗的慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者100例,应用随机数字表法分为对照组与观察组,各50例,对照组给予BiPAP呼吸机辅助通气常规护理,观察组在此基础上,实施医护一体化护理模式,比较两组患者对BiPAP呼吸机治疗的依从性、动脉血气分析指标的变化、呼吸衰竭纠正时间、住院天数、住院费用等指标的差异。结果 观察组患者的依从率为86%,明显高于对照组（64%）,差异有统计学意义（χ2=6.45,P〈0.05）;治疗后24 h观察组血气分析与对照组比较有所改善,差异有统计学意义[（7.32±0.13）比（7.31±0.07）,P〈0.05],治疗后72 h观察组血气分析p H值、动脉血氧分压（Pa O2）、动脉血二氧化碳分压（Pa CO2）与对照组比较有所改善,差异均有高度统计学意义[（7.37±0.09）比（7.34±0.14）,（66.54±8.86）mm Hg比（63.32±7.35）mm Hg,（63.34±10.94）mm Hg比（68.57±9.45）mm Hg,P〈0.01]（1 mm Hg=0.133 k Pa）;观察组平均呼吸衰竭纠正时间、住院天数、住院费用与对照组比较,差异均有统计学意义[（23.59±6.33）h比（34.08±9.21）h,（11.66±3.71）d比（15.42±5.03）d,（1.36±0.44）万元比（1.79±0.52）万元,t=17.23、9.03、11.21,P〈0.05或P〈0.01]。结论 医护一体化护理模式能显著提高患者使用BiPAP呼吸机治疗的依从性,提高治疗效果,并有效降低住院费用。
Objective To investigate the treatment adherence and the treatment effect of integration of medical mode in the treatment of BiPAP ventilator assisted ventilation. Methods 100 cases in Department of Respiratory of the First Hospital of Jiaxing City accepted BiPAP mechanical ventilation treatment of chronic obstructive pulmonary disease with acute exacerbation of respiratory failure in patients with type Ⅱ from June 2012 to June 2014, were randomly divided into the control group and the observation group, with 50 patients in each group, the control group received conven- tional mechanical ventilation BiPAP nursing, observation group was given the implementation of integrated care model of health care on the basis of control group, two groups were compared on the BiPAP ventilator treatment compliance, arterial blood gas analysis changes in respiratory failure correct time, the number of days of hospitalization, and other indicators of differences in hospital costs. Results Compliance rate of observed group of patients was 86%, which was significantly higher than 64% in the control group, the difference was statistically significant （X2=6.45, P 〈 0.05）; com- parison between the observation group after treatment for 24 h and the control group of blood gas analysis of pH, thedifference was statistically significant [ （7.32±0.13） vs （7.31±0.07）, P 〈 0.05], comparison between the observa- tion group after treatment for 72 h and the control group of blood gas analysis of pH, arterial oxygen pressure （PaO2）, arterial carbon dioxide tension （PaCO2）, the de- gree of improvement in the observation group were more than the control group, the differences were statistically significant [（7.37±0.09） vs （7.34±0.14）, （66.54±8.86） mm Hg vs （63.32±7.35） mm Hg, （63.34±10.94） mm Hg vs （68.57±9.45） mm Hg, P 〈 0.01] （1 mm Hg = 0.133 kPa）; comparison between the observation group and control group of the average time to correct respiratory failure, the number of hospital day
出处
《中国医药导报》
CAS
2015年第5期144-148,共5页
China Medical Herald
基金
浙江省嘉兴市重点学科建设项目(编号04-Z-11)
