Value of refined care in patients with acute exacerbation of chronic obstructive pulmonary disease

• Published in: World journal of clinical cases 2021-07, Vol.9 (21), p.5840-5849
• Main Authors: Guo, Su-Ling, Zhang, Ying-Ying, Ye, Mei, Zhang, Na, Wu, Gui-Xia, Ma, Le-Wei
• Format: Article
• Language: English
• Subjects: Retrospective Study
• ISSN: 2307-8960; 2307-8960
• DOI: 10.12998/wjcc.v9.i21.5840

BACKGROUNDUnder physiological conditions, sputum produced during acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can move passively with the cilia in the airway; the sputum is gradually excreted from the depth of the airways through the stimulation of the coughing reflex on the sensory nerve on the surface of the airway. However, when the sputum is thick, the cough is weak, or the tracheal cilia are abnormal, sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung. Furthermore, the presence of pathogenic microorganisms in sputum may cause or aggravate the symptoms of pulmonary infection in patients, which is the main factor leading to AECOPD. Therefore, promoting effective drainage of sputum and maintaining airway opening are key points requiring clinical attention. AIMTo explore the effect of refined nursing strategies in patients with AECOPD and dysphagia. METHODSWe selected 126 patients with AECOPD and difficulty of expectoration at our hospital, and divided them into a refined care group and a routine care group, with 63 cases each, using a random number table. The two groups of patients were treated with expectorant, anti-infection, oxygen inhalation, and other basic treatment measures; patients in the refined care group were given refined nursing intervention during hospitalization, and the routine care group received conventional nursing intervention. The differences in sputum expectoration, negative pressure suction rate, blood gas parameters, dyspnea score measured through the tool developed by the Medical Research Council (MRC), and quality of life were compared between the two groups. RESULTSAfter 7 d of intervention, the sputum expectoration effect of the refined care group was 62.30%, the effective rate was 31.15%, and the inefficiency rate was 6.56%. The sputum expectoration effect of the routine care group was 44.07%, the effective rate was 42.37%, and the inefficiency rate was 13.56%. The refined care group had better sputum expectoration than the routine care group (P < 0.05). The negative pressure suction rate in the refined care group was significantly lower than that of the routine care group during the treatment (22.95% vs 44.07%, P < 0.05). Before the intervention, the arterial oxygen saturation (PaO2) and arterial carbon dioxide saturation (PaCO2) values were not significantly different between the two groups (P > 0.05); the PaO2 and PaCO2 values in the refined care group we