论文部分内容阅读
目的探讨影响慢性阻塞性肺疾病(COPD)急性加重期患者行无创正压通气(NPPV)治疗依从性差的原因,以提高NPPV的治疗效果。方法选择动脉血气分析pH为7.25~7.35的COPD急性加重期行NPPV治疗的患者90例,分析终止NPPV治疗的原因。调查内容包括:职业、对疾病和NPPV治疗认识程度、NPPV治疗的模式选择及设置的压力水平,以及对NPPV治疗抵触的原因。结果 28.9%的患者对COPD了解,仅18.9%的患者认为自己对NPPV了解,对疾病和NPPV均了解的患者占6.7%。56例(62.2%)患者以前从没有接受过NPPV治疗,11例(12.2%)接受过3次或3次以上NPPV治疗。logistic多因素回归分析显示,对COPD和NPPV的认识程度(OR=1.602,95%CI:1.289~1.903,P<0.01)、接受NPPV治疗的次数(OR=1.387,95%CI:1.008~2.103,P<0.01)、患者抵触原因(OR=0.312,95%CI:0.288~0.782,P<0.01)是影响COPD患者治疗依从性的主要影响因素。结论有效的患者教育指导、让患者了解疾病和NPPV治疗的现状,密切观察以便及时发现处理NPPV治疗引起的相关问题,解除患者的抵触心理,是提高NPPV治疗依从性的重要方法。
Objective To investigate the causes of non-invasive positive pressure ventilation (NPPV) treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) to improve the therapeutic effect of NPPV. Methods Arterial blood gas analysis of 90 patients with NPPV in acute exacerbation of COPD at pH ranged from 7.25 to 7.35 was performed to analyze the reasons for termination of NPPV. The survey included occupations, the level of awareness of the disease and NPPV treatment, the modalities of NPPV treatment options and the set stress levels, and the causes of NPPV treatment contradictions. Results 28.9% of patients were aware of COPD that only 18.9% of patients considered themselves NPPV aware, and 6.7% understood both disease and NPPV. Fifty-six patients (62.2%) had never received NPPV before and 11 (12.2%) received three or more NPPVs. Logistic multivariate regression analysis showed that the awareness of COPD and NPPV (OR = 1.602, 95% CI: 1.289-1.903, P <0.01), the number of patients receiving NPPV (OR = 1.387, 95% CI: 1.008-2.103, (OR = 0.312, 95% CI: 0.288-0.782, P <0.01) were the main influencing factors of treatment adherence in COPD patients. Conclusions Effective patient education guide patients to understand the status of the disease and NPPV treatment, close observation in order to promptly find the NPPV treatment-related problems, relieve the patient’s psychological conflict, is to improve the NPPV treatment compliance is an important method.