盐酸氨溴索联合布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期的护理体会

Nursing Experience of Inhalation Ambroxol and Budesonide in the Treatment of AcuteExacerbation of Chronic Obstructive Pulmonary Disease

摘要: 目的：研究盐酸氨溴索联合布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期的护理方法临床疗效。方法：纳入呼吸科2014年2月~3月诊断慢性阻塞性肺疾病急性加重期68例患者，其中男性36例，女性32例，年龄58~82岁。随机分为盐酸氨溴索联合布地奈德雾化吸入组(35例)和盐水雾化吸入组(33例)。护理人员将用物携至病人床边，核对，向病人解释，以取合作，嘱病人取舒适体位，药液注入雾化器内，连接氧气吸入装置后接雾化器，将氧流量调节至2~4 L/min，便可使用，病人手持雾化器，把喷气管放入口中，紧闭口唇，深吸气，可使药液充分达至支气管和肺内，吸气后再屏气1~2秒，则效果更好，整个雾化过程持续10~20分钟，将药液雾化完全。治疗完毕，关闭氧气，取下雾化器，清理用物，消毒处理。治疗时间选择上午和下午各吸入治疗一次，一般选择饭前进行，有利于吸入后排痰，或避免特殊药物引起的恶心呕吐。体位的选择最好选择坐卧，有利于吸入药液沉积到细支气管及肺泡。吸入治疗后进行拍背，从下而上，从外向内循序进行，并鼓励病人深吸气后，用力咳出，同时观察痰的性状、颜色、量的变化，以评价疗效。用t检验比较两组患者痰量变稀薄时间、住院时间差异。结果：观察组患者痰量变稀薄时间、住院时间明显低于对照组，经统计学分析，p < 0.01，二者差异具有统计学意义。结论：盐酸氨溴索联合布地奈德雾化吸入治疗较盐水雾化吸入效果更佳，具有重要的临床意义。

Abstract: Objective: To investigate the nursing efficacy of inhalation ambroxol and budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: 68 patients diagnosed as AECOPD were enrolled during February 2014-March 2014 in department of Respiratory and Critical Care Medicine, including 36 men and 32 women, aged 58 - 82 years old. The subjects were randomly divided into the ambroxol and budesonide inhalation group (35 cases) and the brine inhalation group (33 cases). Nurses will bring substance to the patients’ bedside, check, explain to the patient to get cooperation and instruct the patient to take a comfortable position. The liquid drugs were injected into the atomizer, which was connected to the oxygen inhalation device. The oxygen flow was adjusted to 2 - 4 L/min. Patients handheld the jet tube into the mouth, closed lips, inhaled deeply to allow liquid to fully achieve the bronchi and lungs and held breath 1 - 2 seconds. The whole process lasted 10 - 20 minutes. When the treatment completed, nurses turned off the oxygen, removed the atomizer, cleaned up with things which would be disinfected. Patients received the treatment once in the morning and in the afternoon, usually before meals, being conductive to expectoration, or avoiding specific drug-induced nausea and vomiting. The best position was sitting or lying, in favor of inhalation liquid drug deposited into the bronchioles and alveoli. After the inhalation therapy, nurses shot back orderly from the bottom to up and the inside to outward and encouraged patients to take a deep breath and vigorously cough up the phlegm and observed the sputum traits, color and volume changes in order to evaluate the efficacy of the treatment. Comparison between the groups of data was evaluated using t-test. Results: sputum reduced time and hospitalization time of patients in the observation group were significantly lower than the control group. The difference was statistically significant (p < 0. 01). Conclusion: Ambroxol hydrochloride budesonide inhalation was better than the saline inhalation, which has an important clinical significance.