Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2021; 9(21): 5840-5849
Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5840
Value of refined care in patients with acute exacerbation of chronic obstructive pulmonary disease
Na Na, Su-Ling Guo, Ying-Ying Zhang, Mei Ye, Na Zhang, Gui-Xia Wu, Le-Wei Ma
Na Na, Gui-Xia Wu, Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Su-Ling Guo, Department of Hematology, The Eighth Medical Center, General Hospital of Chinese PLA, Beijing 100091, China
Ying-Ying Zhang, Operation Room, The Fourth People’s Hospital of Jinan, Jinan 250031, Shandong Province, China
Mei Ye, Department of Gynecology and Pediatrics, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
Na Zhang, Department of Cardiovascular Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong Province, China
Le-Wei Ma, Department of Respiratory and Critical Care Medicine, Jinan Central Hospital, Jinan 250013, Shandong Province, China
Author contributions: Na N and Guo SL design the study; Zhang YY drafted the work; Ye M and Wu GX collected the data; Wu GX analyzed and interpreted the data; Zhang N and Ma LE wrote the article.
Institutional review board statement: The study was approved by the Medical Ethics Committee of the Affiliated Hospital of Qingdao University.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that there is no conflict of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Le-Wei Ma, Bachelor degree, Supervisor nurse, Department of Respiratory and Critical Care Medicine, Jinan Central Hospital, No. 105 Jiefang Road, Jinan 250013, Shandong Province, China. mlwjn0828@163.com
Received: February 23, 2021
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
Processing time: 147 Days and 23.1 Hours
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

To explore the effect of refined nursing strategies on patients AECOPD and dysphagia.

Research methods

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 inhalation, and other basic treatments measures. Patients in the study group were given refined nursing intervention during hospitalization, and the control group was given conventional nursing intervention. The differences in sputum expectoration, negative pressure suction rate, blood gas parameters, dyspnea score [medical research council (MRC)], and quality of life were compared between the two groups.

Research results

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).

Research conclusions

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.

Research perspectives

Refined nursing strategies for AECOPD patients with difficulty expectorating play a positive role in promoting expectoration and improving clinical symptoms and quality of life.