ABSTRACT
Objective To observe the application effect of critical care professional nursing team applied to sequential mechanical ventilation in the treatment of chronic obstructive pulmonary disease (COPD) with respiratory failure. Methods Totally 80 patients of COPD with respiratory failure from May 2014 to April 2015 were divided into study group and control group by random number table method, 40 patients in each group. Study group was applied to critical care professional nursing team. Control group was given routine nursing. The two groups were treated for 4 weeks. The clinical indicators of positive end expiratory pressure (PEEP), pressure support ventilation (PSV), carbon dioxide partial pressure (PaCO2), oxygen partial pressure (PaO2), forced expiratory volume in one second (FEV1), heart rate, arterial systolic blood pressure, respiratory rate in two groups were compared. The clinical indicators such as the duration of the stay, the duration of the total ventilation, and the time of invasive ventilation, etc, in two groups were compared;and nursing satisfaction was also compared. Results Before nursing, there were no statistical differences between the study group and the control group in PaCO2, PaO2, FEV1, heart rate, systolic arterial blood pressure, respiration rate and PEEP, PSV indicators (t=0.04-0.63, P>0.05). And after the intervention, the above indicators of the study group were (36.4±2.0) mmHg (1 mmHg=0.133 kPa), (94.7± 4.8) mmHg, (45.2 ± 16.0) %, (84.2 ± 4.3) beats/min, (94.2 ± 5.3) mmHg, (15.2 ± 3.0) times/min, (3.6 ± 1.2) mmHg, (10.2 ± 2.0) ml and (48.5 ± 5.3) mmHg, (88.3 ± 4.1) mmHg, (36.9 ± 14.1)%, (92.4 ± 6.2) beats/min, (110.4 ± 6.2) mmHg, (20.9 ± 4.1) times/min, (4.2 ± 1.6) mmHg, (13.9 ± 2.4) ml in the control group. The differences were statistically significant (t=4.37-13.51, P<0.01). After nursing care, the study group of patients with clinical indicators such as admission time, total duration of ventilation, the time of invasive ventilation were (12.5±1.5) d,(10.2±2.6) h,(5.2±2.1) h,while (18.2±2.6) d,(15.9±1.1) h,(7.9±2.9) h in the control group, the differences were statistically significant (t=12.01, 12.77, 4.77, P<0.01).The nursing satisfaction rate was 80.0% (32/40) in the study group while 62.5% (25/40) in the control group, the difference was statistically significant (χ2=6.30, P < 0.01). Conclusions Sequential mechanical ventilation therapy and nursing care in patients with COPD can significantly improve the clinical symptoms, improve nursing satisfaction, it is worthy of clinical promotion.
ABSTRACT
Objective To investigate the influence of Xiyanping injections therapy on inflammation factors and lung function for old patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD).Methods Ninety-two patients with AECOPD were randomly divided into the control group (n =46) and observation group(n =46).Patients in control group were given conventional treatment,in observation group were given XiYanPing injections for 2 weeks treatment on the basis of treatment of control group.The C-reactive protein(CRP),blood sedimentation rate (ESR),interleukin 10 (IL-10),1 s forced expiratory volume (FEV1),forced vital capacity (FVC),FEV1/FVC change and clinical effect of the two groups were recorded.Results There was no statistically significant difference in terms of CRP,ESR and IL-10 between the two groups before treatment (P ＞ 0.05).After treatment,CRP and ESR in control group were reduced from (35.6 ±9.8) mg/L and (56.2 ± 16.4) mm/h to (14.2 ± 8.1) mg/L and (22.4 ± 11.6) mm/1 h and the difference was significant (t =-14.515,-12.008;P ＜ 0.05),while in observation group decreased from (36.4 ± 8.2) mg/L,(54.6 ± 15.4) to (8.2 ± 6.2) mg/L,(16.8 ± 9.6) mm/h and the difference was significant (t =-18.468,-15.249;P ＜ 0.05).Meanwhile,the level of IL-10 in the two groups significantly increased and the observation group showed more.IL-10 in control group increased from (168.8 ± 62.4) ng/L to (212.4 ± 85.6) ng/L and the difference was significant(t =5.468,P ＜ 0.05),and in observation group increased from (172.8 ± 65.1) ng/L to (266.4 ± 92.6) ng/L and the difference was significant (t =6.368,P ＜ 0.05).The FEV1 and FVC were markedly increased after treatment and the observation group showed increase more.FEV1and FVC in control group were increased from (1.41 ±0.15) L and (2.62 ±0.88) L to (1.62 ± 0.18) L and (2.89 ± 0.92) L,and the differences were significant (t =2.186,2.415 ; P ＜ 0.05).While in observation group,FEV1 and FVC were increased from (1.42 ± 0.16) L and (2.59 ± 0.84) L to (1.84 ±0.21) L and (3.12 ± 0.94) L,and the differences were significant (t =4.366,4.585 ; P ＜ 0.05).Total efficacy of observation group was 91.3％ (42/46),obviously higher than that of control group(78.3％ (36/46) ; x2 =4.658 ;P ＜ 0.05).Conclusion Xiyanping injections can reduce the inflammatory response in patients with AECOPD,improve lung function and the effect of treatment.
ABSTRACT
Objective To evaluate the value of neck blood vessel colored doppler ultrasound (NBVCDU) and magnetic resonance angiography (MRA) to extracranial carotid artery stenosis in patients with transient ischemic attack (TIA).Methods After implementing NBVCDU and MRA examinations at the same time,45 TIA patients with at least one examination showing arteriostenosis in extracranial section were chosen to carry out cerebral digital subtraction angiography( DSA ),then the stenosis rate was calculated by American symptomatic carotid endarterectomy trial (NASCET) method.Results Regarding DSA as the gold standard,for 45 TIA patients that having 180 arteriostenosis in extracranial section, sensitivity,specificity,accuracy of NBVCDU examination was 93.51% ,95.15% ,94.44%, Kappa = 0.735; sensitivity,specificity,accuracy of MRA was 92.21% ,94.17% ,93.33% , Kappa =0.681; sensitivity,specificity,accuracy of NBVCDU combined with MPA was 97.40% ,99.03% ,98.33%, Kappa = 0.872.Conclusions The sensitivity and accuracy of arteriostenosis in extracranial section by NBVCDU examination is higher than that by MRA, and it is suitable in the crowd primary examination.NBVCDU combined with MRA has shown good consistence with DSA for diagnosing arteriostenosis in extracranial section,but can't replace DSA comlpetely.