急诊绿色通道优化联合多学科协作护理在COPD急性加重期并呼吸衰竭患者救治中的应用

董思珍; 朱建俊; 鲁雅儿

doi:10.16766/j.cnki.issn.1674-4152.004068

急诊绿色通道优化联合多学科协作护理在COPD急性加重期并呼吸衰竭患者救治中的应用

doi: 10.16766/j.cnki.issn.1674-4152.004068

杭州市余杭区第二人民医院急诊科，浙江杭州 311121

基金项目:

浙江省医药卫生科技计划项目 2024XY019

详细信息

通讯作者:
董思珍，E-mail：sz278321733@163.com

中图分类号: R473.56 R563.8
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- 文章访问数: 14
- HTML全文浏览量: 14
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2024-08-17
- 网络出版日期: 2025-09-04

Application of emergency green channel optimization combined with multidisciplinary collaborative nursing in the treatment of patients with acute exacerbation of COPD and respiratory failure

Emergency Department, the Second People's Hospital of Yuhang District, Hangzhou, Zhejiang 311121, China

摘要

摘要: 目的慢性阻塞性肺疾病急性加重期(AECOPD)并呼吸衰竭病情危重，若救治不及时可危及患者生命，本研究探讨急诊绿色通道优化联合多学科协作护理在AECOPD患者救治中的应用效果，从而为提高危重症患者的生存率及急救护理水平提供理论参考。方法选取2022年1月—2023年12月于杭州市余杭区第二人民医院急诊救治的101例AECOPD并呼吸衰竭患者为研究对象，根据入院先后顺序将2022年1—12月救治的50例患者作为对照组，实施传统模式的急诊护理干预；2023年1—12月救治的51例患者作为观察组，实施急诊绿色通道优化联合多学科协作护理干预。比较2组抢救效果、血气指标、护理质量及患者家属护理满意度。结果观察组干预后静脉通道建立时间、辅助检查时间、治疗方案确定时间、抢救介入时间及急诊停留时间均短于对照组(P＜0.05)；抢救成功率为98.04%(50/51)，高于对照组的84.00%(42/50, P＜0.05)，意外发生率为1.96%(1/51), 略低于对照组的14.00%(7/50，P＞0.05)；动脉血氧分压(PaO₂)、氧合指数(PaO₂/FiO₂)及血氧饱和度(SaO₂)均高于对照组(P＜0.05)；护理质量各维度评分均高于对照组(P＜0.05)；家属护理满意度高于对照组(P＜0.05)。结论急诊绿色通道优化联合多学科协作护理可缩短AECOPD并呼吸衰竭患者院内抢救反应时间，提高救治效果，改善血气指标和护理质量，提升家属护理满意度。
- 慢性阻塞性肺疾病 /
- 综合护理 /
- 急诊绿色通道 /
- 多学科协作 /
- 抢救成功率
Abstract: Objective To explore the application of emergency green channel optimization combined with multidisciplinary collaborative nursing in the treatment of critically ill patients with acute COPD exacerbation (AECOPD) and respiratory failure, which can be life-threatening if not treated in time, so as to provide theoretical reference for improving the survival rate and emergency nursing level of critically ill patients. Methods A total of 101 patients with AECOPD and respiratory failure who were treated in the emergency department of the Second People's Hospital of Yuhang District, Hangzhou City from January 2022 to December 2023 were selected as the research subjects. According to the order of admission, 50 patients treated from January 2022 to December 2022 were recorded as the control group Group, implement emergency nursing intervention in the traditional mode; From January 2023 to December 2023, 51 patients treated were recorded as the observation group and implemented the optimization of the emergency green channel combined with multidisciplinary collaborative nursing intervention. The rescue effects, blood gas indicators, nursing quality and the nursing satisfaction of patients' families were compared between the two groups. Results The time of venous channel establishment, auxiliary examination, treatment plan determination, rescue intervention, and emergency stay in the observation group were all shorter than those in the control group (P < 0.05). The success rate of rescue was 98.04% (50/51), which was higher than that of the control group [84.00% (42/50), P < 0.05], and the accident rate was 1.96% (1/51), which was slightly lower than that of the control group [14.00% (7/50), P>0.05]. Arterial partial oxygen pressure (PaO₂), oxygenation index (PaO₂/FiO₂), and blood oxygen saturation (SaO₂) were higher than those in the control group (P < 0.05). The scores of all dimensions of nursing quality were higher than those of the control group (P < 0.05). The nursing satisfaction of family members was higher than that of the control group (P < 0.05). Conclusion Emergency green channel optimization combined with multidisciplinary collaborative nursing can shorten the hospital rescue response time of patients with AECOPD and respiratory failure, improve the treatment effect, improve blood gas index and nursing quality, and enhance the nursing satisfaction of family members.
- Chronic obstructive pulmonary disease /
- Comprehensive nursing /
- Emergency green channel /
- Multidisciplinary collaboration /
- Success rate of rescue

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表 1 2组AECOPD并呼吸衰竭患者一般资料比较

Table 1. Comparison of general data between the two groups of patients with AECOPD and respiratory failure

组别	例数	性别(男性/ 女性，例)	年龄(x±s，岁)	BMI (x±s)	COPD病程(x±s，年)	吸烟(例)	合并疾病(例)			呼吸困难评分(x±s，分)
组别	例数	性别(男性/ 女性，例)	年龄(x±s，岁)	BMI (x±s)	COPD病程(x±s，年)	吸烟(例)	糖尿病	高血压	冠心病	呼吸困难评分(x±s，分)
对照组	50	31/19	62.34±6.11	23.45±3.44	4.56±1.40	24	10	23	5	2.80±0.56
观察组	51	33/18	62.45±7.09	23.60±4.77	4.78±1.01	19	7	25	3	2.63±0.67
统计量		0.080^a	0.083^b	0.181^b	0.907^b	1.192^a	0.710^a	0.092^a	0.158^a	1.382^b
P值		0.778	0.934	0.857	0.367	0.274	0.399	0.761	0.691	0.170
注：^a为χ²值，^b为t值。

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表 2 2组AECOPD并呼吸衰竭患者干预后抢救时效比较(x±s, min)

Table 2. Comparison of duration in rescue between the two groups of patients with AECOPD and respiratory failure after intervention (x±s, min)

组别	例数	静脉通道建立时间	辅助检查时间	治疗方案确定时间	抢救介入时间	急诊停留时间
对照组	50	5.46±1.12	20.09±4.11	20.98±3.56	14.67±3.10	25.71±5.10
观察组	51	3.89±1.34	13.01±3.12	13.31±3.09	9.23±2.10	18.90±4.07
t值		6.382	9.763	11.570	10.343	7.425
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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表 3 2组AECOPD并呼吸衰竭患者干预后抢救成功率和意外发生率比较[例(%)]

Table 3. Comparison of rescue success rate and accident incidence between the two groups of patients with AECOPD and respiratory failure after intervention[cases (%)]

组别	例数	抢救成功	意外发生
对照组	50	42(84.00)	7(14.00)
观察组	51	50(98.04)	1(1.96)
χ²值		4.523	3.502
P值		0.033	0.061

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表 4 2组AECOPD并呼吸衰竭患者急救前后血气指标比较(x±s)

Table 4. Comparison of blood gas index between the two groups of patients with AECOPD and respiratory failure before and after first aid (x±s)

组别	例数	PaO₂(mmHg)		PaO₂/FiO₂(mmHg)		SaO₂(%)
组别	例数	急救前	急救后	急救前	急救后	急救前	急救后
对照组	50	65.23±8.11	75.64±10.11^b	380.12±10.34	407.45±20.09^b	84.32±8.21	90.12±7.12^b
观察组	51	65.17±9.09	80.98±9.42^b	380.24±15.67	425.56±16.75^b	84.09±9.13	93.12±5.24^b
统计量		0.035^a	15.671^c	0.045^a	20.981^c	0.145^a	16.451^c
P值		0.972	＜0.001	0.964	＜0.001	0.885	＜0.001
注：^a为t值，^c为F值; 与同组急救前比较，^bP＜0.05。1 mmHg=0.133 kPa。

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表 5 2组AECOPD并呼吸衰竭患者干预后护理质量比较(x±s，分)

Table 5. Comparison of care quality between the two groups of patients with AECOPD and respiratory failure after intervention (x±s, points)

组别	例数	风险评估	护理执行	规避纠纷	应急能力	患者管理
对照组	50	7.67±1.45	8.23±1.21	8.11±1.02	8.09±1.34	8.22±0.98
观察组	51	8.45±1.42	9.09±0.66	9.12±0.74	9.22±0.55	9.17±0.76
t值		2.731	4.446	5.704	5.563	5.450
P值		0.008	＜0.001	＜0.001	＜0.001	＜0.001

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表 6 2组AECOPD并呼吸衰竭患者干预后家属护理满意度比较[例(%)]

Table 6. Comparison of family care satisfaction between the two groups of patients with AECOPD and respiratory failure after intervention[cases (%)]

组别	例数	十分满意	满意	一般	不满意	非常不满意	总满意
对照组	50	7(14.00)	31(62.00)	10(20.00)	1(2.00)	1(2.00)	38(76.00)
观察组	51	12(23.53)	35(68.63)	3(5.88)	1(1.96)	0	47(92.16)
注：2组总满意度比较，χ²=4.944，P=0.026。

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