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目的探讨实施临床路径对无创正压通气(non-invasive positive pressure ventilation,NPPV)治疗慢性阻塞性肺疾病(COPD)并呼吸衰竭效果的影响。方法选择收治的100例COPD合并呼吸衰竭的患者随机分为治疗组和对照组,各50例。两组患者均给予常规药物加无创正压通气治疗,对照组采用常规治疗进行处理,治疗组采用制订好的临床路径进行治疗。比较两组患者对无创正压通气治疗的依从性、达到人机协调的时间、动脉血气分析指标的变化、住院天数、住院费用及并发症发生率的差异。结果治疗组患者的依从性好于对照组(P<0.05),达到人机协调的时间、平均住院天数、住院费用和并发症的发生率等少于对照组(均P<0.05),治疗24 h后动脉血气分析指标改善更明显(均P<0.05)。结论临床路径能显著提高患者的依从性,提高无创正压通气的治疗效果,并有效降低住院费用。
Objective To investigate the effect of clinical pathway on the treatment of chronic obstructive pulmonary disease (COPD) and respiratory failure by non-invasive positive pressure ventilation (NPPV). Methods Selected 100 patients with COPD and respiratory failure were randomly divided into treatment group and control group, 50 cases each. Two groups of patients were given conventional drugs plus noninvasive positive pressure ventilation, the control group treated with conventional treatment, the treatment group with well-established clinical pathways for treatment. The compliance of noninvasive positive pressure ventilation was compared between the two groups, the time of man-machine coordination, the change of arterial blood gas analysis index, hospitalization days, hospitalization expenses and the incidence of complications were compared. Results The compliance of patients in the treatment group was better than that of the control group (P <0.05), and the time to achieve the coordination between the two groups was less than that of the control group (all P <0.05), and the average length of stay, hospitalization expenses and complications were lower Arterial blood gas analysis index improved more obviously after h (all P <0.05). Conclusion The clinical pathway can significantly improve patient compliance, improve the therapeutic effect of non-invasive positive pressure ventilation, and effectively reduce hospitalization costs.