陈春兰 魏道华 杨奕妙 黄党生

【摘要】 目的 探讨循证护理干预联合雾化吸入在老年肺源性心脏病患者中的影响。方法 48例老年肺源性心脏病患者作为研究对象， 按照患者的就诊顺序分为研究组与对照组， 每组24例。研究组给予雾化吸入治疗联合循证护理， 而对照组仅给予雾化吸入治疗和本科常规护理。比较两组患者干预前后心肺功能指標变化情况及自护能力。结果 干预前， 两组患者第一秒用力呼气容积（FEV1）、残气量/肺总量（RV/TLC）、6 min步行距离（6MWD）比较差异均无统计学意义（P>0.05）；干预后， 研究组患者FEV1、RV/TLC、6MWD分别为（1.35±0.32）L、（53.58±7.68）%、（202.65±9.19）m， 均显著优于对照组的（1.20±0.31）L、

（56.57±6.99）%、（182.04±8.51）m， 差异均具有统计学意义（P<0.05）。干预前， 两组患者健康知识、合理用药、心理乐观、合理饮食、自理能力等自护能力评分比较差异均无统计学意义（P>0.05）；干预后， 研究组健康知识、合理用药、心理乐观、合理饮食、自理能力等自护能力评分均显著高于对照组， 差异均具有统计学意义（P<0.05）。结论 循证护理干预联合雾化吸入对老年肺源性心脏病患者心肺功能改善具有显著效果， 同时对提升患者自护能力具有积极作用， 适合推广使用。

【关键词】 肺源性心脏病；循证护理干预；雾化吸入；老年人；心功能；肺功能

DOI：10.14163/j.cnki.11-5547/r.2018.10.089

【Abstract】 Objective To discuss the effect of evidence-based nursing intervention combined with atomization inhalation on elderly patients with pulmonary heart disease. Methods A total of 48 elderly patients with pulmonary heart disease were divided by visiting order into research group and control group， with

24 cases in each group. The research group received atomization inhalation combined with evidence-based nursing intervention therapy， and the control group received atomization inhalation combined with conventional nursing. Comparison were made on cardio-pulmonary function indicators changes before and after intervention and self-care ability between the two groups. Results Before treatment， both groups had no statistically significant difference in forced expiratory volume in one second （FEV1）， residual volume / total lung capacity （RV/TLC），

6 minutes walking distance （6MWD） （P>0.05）. After intervention， the research group had obviously better FEV1， RV/TLC and 6MWD respectively as （1.35±0.32） L， （53.58±7.68）% and （202.65±9.19） m than （1.20±0.31） L， （56.57±6.99） % and （182.04±8.51） m in the control group， and their difference was statistically significant （P<0.05）. Before intervention， both groups had no statistically significant difference in self-care ability of health knowledge， rational drug use， optimistic psychology， reasonable diet and self-care ability （P>0.05）. After intervention， the research group had obviously higher self-care ability of health knowledge， rational drug use， optimistic psychology， reasonable diet and self-care ability， and the difference was statistically significant （P<0.05）. Conclusion Combination of evidence-based nursing intervention combined with atomization inhalation shows remarkable effect in improving cardio-pulmonary function of patients with pulmonary heart disease， while showing positive effect in improving self-care ability of patients. It is suitable for promotion and application.

【Key words】 Pulmonary heart disease； Evidence-based nursing intervention； Atomization inhalation； Elderly patients； Cardiac function； Pulmonary function

慢性肺源性心脏病是呼吸科较为常见的疾病， 主要为老年患者。由于肺动脉血管、肺组織或者胸廓慢性病变的存在， 造成了肺组织和结构的改变， 进而影响其正常的功能， 肺血管阻力增大， 肺动脉压升高， 进一步发展导致有心肥大， 严重者发生右心衰竭[1， 2]。有……