陈明君　丁群力　陈益峰

[摘要] 目的 探討床旁端坐位护理对慢性阻塞性肺疾病（COPD）患者机械通气时间的影响。 方法 选择2013年1月～2014年1月我院收治的96例慢性阻塞性肺疾病患者作为研究对象，根据护理方式不同将其分为对照组与观察组，每组48例。对照组给予常规治疗和护理，观察组在对照组的基础上给予床旁端坐位护理，对比分析两组患者的机械通气时间、住院时间、护理前后血气指标变化情况等。 结果 两组患者护理前的PaO2、PaCO2、SpO2水平比较，差异无统计学意义（P>0.05）；护理后，观察组的PaO2、PaCO2、SpO2改善水平优于对照组（P<0.05）。观察组机械通气时间、住院时间均低于对照组，呼吸机成功撤机率为85.4%，高于对照组的64.6%，呼吸机相关肺炎的发生率为4.2%，低于对照组的22.9%，差异有统计学意义（P<0.05）。 结论 床旁端坐位护理可有效改善慢性阻塞性肺疾病患者的通气功能，减少机械通气时间，降低呼吸机相关肺炎的发生情况，缩短住院时间，提高患者生存质量，其临床应用价值高。

[关键词] 慢性阻塞性肺疾病；床旁端坐位；机械通气；呼吸机相关性肺炎

[中图分类号] R473 [文献标识码] B [文章编号] 1673-9701（2015）35-0127-04

[Abstract] Objective To explore influences of bedside sitting nursing on mechanical ventilation duration of patients with chronic obstructive pulmonary disease（COPD）. Methods Ninety six patients with COPD admitted in the hospital from January 2013 to January 2014 were selected as research subjects， who were divided into control group and observation group with 48 patients in each group according to different nursing modes. The patients in the control group were subjected to conventional treatment and nursing， while the patients in the observation group were subjected to bedside sitting nursing on the basis of that applied in the control group， mechanical ventilation duration， length of hospital stay， changes in blood and vigor indexes before and after nursing of two groups of patients were compared and analyzed. Results The differences in comparisons of PaO2， PaCO2 and SpO2 levels of patients in two groups had no statistically significant before nursing （P>0.05）； and PaO2， PaCO2 and SpO2 levels of patients in the observation group after nursing were better than those indexes of patients in the control group （P<0.05）. Mechanical ventilation duration and length of hospital stay of patients in the observation group were lower than those of patients in the control group， the successful removal of respirators used in the observation hit was 85.4%， was higher than 64.6% in the control group， the incidence of ventilator associated pneumonia was 4.2%， was lower than 22.9% in the control group， and the difference was significant （P<0.05）. Conclusion The bedside sitting position can effectively improve the ventilation function of patients with COPD， reduce the duration of mechanical ventilation， decrease the occurrence of ventilator associated pneumonia， shorten hospitalization time， and improve the quality of survival， delivering high clinical application value.

[Key words] Chronic obstructive pulmonary disease； Bedside sitting position； Mechanical ventilation； Ventilator-associated pneumonia

慢性阻塞性肺疾病是临床常见的一种慢性呼吸系统疾病，该病发生人群主要集中于中老年人，近年来其发病率呈现不断上升的趋势[1]。慢性阻塞性肺疾病患者其肺部气肿、支气管远端气道弹性下降，从而造成患者呼吸困难，且其血氧含量较低，急性加重期时常合并呼吸衰竭，对患者健康及生命安全造成严重影响[2]。目前，临床以呼吸支持治疗为主，如使用无创机械通气治疗。但机械通气时间过长易引起各种并发症，且增加患者的治疗成本和住院时间[3]。鉴于此，笔者以96例COPD患者为研究对象，探讨床旁端坐位对其机械通气时间的影响，现报道如下。

1 资料与方法

1.1 一般资料

选取2013年1月～2014年1月我院收治的96例慢性阻塞性肺疾病患者作为研究对象，根据护理方式不同将其分为对照组与观察组，每组48例。对照……