【摘要】 目的:研究分析给予急性左心衰竭患者不间断性的护理方式对患者病情的影响效果。方法:选取2012年10月-2013年10月在本院治疗的74例急性左心衰患者,按照随机数字表法将其分为对照组和试验组各37例。两组患者均给予相同的治疗措施,其中对照组仅给予常规护理,试验组在此基础上给予抢救、心理、营养及生活等方面的不间断性护理,观察比较两组患者护理前后收缩压和心率的变化及患者对护理人员护理措施满意度的差异。结果:两组护理前的收缩压和心率比较差异均无统计学意义(P>0.05),试验组经过不间断护理后的收缩压和心率均明显低于对照组及护理前,差异均有统计学意义(P<0.05),而对照组护理前后的收缩压和心率比较差异无统计学意义(P>0.05)。试验组患者对护理人员护理措施满意率83.78%明显高于对照组的54.05%,差异有统计学意义(P<0.05)。结论:不间断性护理方式对患者的病情影响较显著,使左心衰竭患者抢救成功率明显提高,值得在临床上推广使用。 【关键词】 急性左心衰; 不间断性护理方式; 病情影响 【Abstract】 Objective:To study and analyze effects of continous nursing on the disease condition of patients with acute left heart failure.Method:74 patients with acute left heart failure in our hospital from October 2012 to October 2013 were selected,they were randomly divided into the experimental group and the control group,37 cases in each group.The two groups received same treatment,but the control group was given conventional nurisng,the experimental group was given continous nursing in salvaging,psychology,nutrition and life.The changes of systolic pressure and heart rate,the differences in patient satisfaction with nursing care measures between the two grous were observed and compared.Result:There were no significant differences in systolic pressure and heart rate between the two groups(P>0.05).After continous nursing,the systolic pressure and heart rate of the experimental group were significantly lower than the control group and before continous nursing,the differences were statistically significant(P<0.05),and there were no significant differences in the control group before and after nursing(P>0.05).The satisfaction rate of patients for nursing measures in the experimental group was 83.78%,it was significantly higher than 54.05% of the control group,the difference was statistically significant(P<0.05).Conclusion:Effects of continous nurisng on patients are obvious,it can significantly improved the success rate of rescue in the patients with left heart failure,is worthy of clinical use. 【Key words】 Acute left heart failure; Continous nursing mode; Effects on disease condition First-author’s address:The Fifth Affiliated Hospital of Southern Medical University,Conghua 510900,China doi:10.3969/j.issn.1674-4985.2014.18.037 心脏排血量功能的减退,心脏排血量不足不能满足全身组织代谢需要的一种病理现象称为心功能不全,简称心衰[1]。而肺淤血导致急性左心衰竭的发生,临床表现主要有急性肺水肿,并且常伴有休克,常见的症状为呼吸困难、端坐呼吸、咳嗽、面色灰白、大汗、烦躁不安、乏力等[2]。急性左心衰若不能有效的处理,严重者会导致死亡,并且预后的效果不良,有研究表明,对于急性左心衰的患者需要紧急的措施,拟定护理方案,精心及合理的护理方式对于治疗急性左心衰至关重要[3]。本研究对于急性左心衰的患者给予不间断性护理方式,为了更深入的研究分析,现将研究分析的报告结果如下: 1 资料与方法 1.1 一般资料 选取2012年10月-2013年10月在本院治疗的74例急性左心衰患者,按照随机数字表法将其分为对照组和试验组各37例。对照组37例患者中,女17例,男20例,年龄45~78岁,平均(52.2±3.3)岁;试验组37例患者中,女18例,男19例,年龄42~76岁,平均(50.8±2.3)岁。所有患者在入院前的主诉均为突然间呼吸困难、口唇发紫发绀、咳嗽并且咳粉红泡沫样痰、尿量少、脾气较暴躁等;入院检查显示,两肺可闻及干性及湿性啰音及哮鸣音。两组患者的年龄、性别等一般资料比较差异均无统计学意义(P>0.05),具有可比性。
1.2 方法 两组患者均给予抢救及治疗措施,但对照组给予常规护理,试验组在此基础上给予抢救、心理、营养及生活等方面的不间断性护理。主要的护理措施如下:(1)在抢救过程中,护理人员根据患者的病情给予积极的护理措施,如对于护理困难、烦躁不安等症状的患者应取端坐位来保持体力;为患者建立两个静脉通道吸入纯氧6~8 L;通过密切监测心电、血压、血氧饱和度等时刻注意心率及心率的变化;要熟练掌握对抗心力衰竭药物的用法,尽可能地避免用药后出现副作用及中毒现象。(2)基础护理:保持室内环境的适宜,给予患者皮肤的护理,对医用品的妥善保管等基础护理。(3)心理护理:大部分患者都会有一定程度的心理压力,护理人员要给患者一定的心理支持,使其缓解紧张的心理压力,从而增加对护理人员的信任感。(4)营养护理:患者要注意饮食,护理人员要嘱患者禁忌高脂肪、高钠饮食及暴饮暴食等。(5)人性化护理:护理人员的态度要和蔼可亲,护理人员应耐心解答患者对病情的任何疑问。 |