Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5840
Peer-review started: February 23, 2021
First decision: March 25, 2021
Revised: April 6, 2021
Accepted: May 21, 2021
Article in press: May 21, 2021
Published online: July 26, 2021
Under physiological conditions, sputum produced during acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can move passively with the cilia in the airway, is gradually excreted from the depth of the airway, and is coughed out of the body by stimulating the sensory nerve on the surface of the airway to cough. However, when sputum is thick, cough is weak, or trachea cilia are abnormal, sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung. Furthermore, because sputum contains a variety of pathogenic microorganisms, it can cause or aggravate the symptoms of pulmonary infection in patients, which is the main factor leading to AECOPD.
Promoting effective drainage of sputum and maintaining airway opening are the key points of clinical attention. It is of great significance to the health of AECOPD patients.
To explore the effect of refined nursing strategies on patients AECOPD and dysphagia.
A total of 126 patients with AECOPD and difficulty expectoration at our hospital were selected as the research subjects. They were divided them into either a refined care group or a routine care group with 63 cases each by using a random number table. The two groups of patients were treated with expectorant, anti-infection, oxygen inha
After 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 control group was 44.07%, the effective rate was 42.37%, and the inefficiency rate was 13.56%. The negative pressure suction rate of 22.95% of the patients in the refined care group was lower than the 44.07% of the control group during the treatment, and the difference was statistically significant (P < 0.05). Before the intervention, the PaO2 and PaCO2 values of the two groups were not significantly different (P > 0.05); the PaO2 and PaCO2 values of patients in the refined care group were comparable to those of the control group after 7 d of intervention (P > 0.05). Before the intervention, there was no significant difference in MRC score between the two groups (P > 0.05); the MRC score of the refined care group was lower than that of the control group after 7 d of intervention, but the difference was not statistically significant (P > 0.05). Before intervention, there was no significant difference in the symptoms, activities, disease impact, or St. George’s Respiratory questionnaire (SGRQ) total scores between the two groups (P > 0.05); after the intervention for 7 d, the symptoms, activities, and total scores of SGRQ were higher in the refined care group than in the control group, but the difference was not statistically significant (P > 0.05).
When the sputum is thick, cough is weak, or trachea cilia function is abnormal in AECOPD patients, sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung. Patients with AECOPD who have difficulty expectorating sputum to adopt refined nursing strategies have a positive effect in promoting expectoration and improving clinical symptoms and quality of life.
Refined nursing strategies for AECOPD patients with difficulty expectorating play a positive role in promoting expectoration and improving clinical symptoms and quality of life.