目的

分析预警机制全方位无盲点管理模式对慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）并发呼吸衰竭（respiratory failure，RF）住院时间和不良事件的影响。

方法

选取我院2022 年1 月至2024 年1 月我院收治的AECOPD 并RF 患者129 例，随机分为观察组65 例和对照组64 例，对照组予以常规管理，观察组采用预警机制下全方位无盲点管理。 对比两组ICU 治疗时间、机械通气时间、住院时间差异，分析救治前后Kolcaba 舒适状况量表（general comfort questionnaire，GCQ）、 生活质量St George' s 呼吸问卷（St George' s respiratory questionnaire，SGRQ）及住院期间不良事件呼吸机相关性肺炎风险（ventilator-associated pneumonia，VAP）、呼吸机依赖（ventilator dependence，VD）、管道堵塞、面罩漏气、窒息差异。

结果

观察组ICU 治疗时间、机械通气时间及住院时间分别为（16.68±2.01）d、（8.28±1.36）d、（29.44±3.95）d 低于对照组（18.07±1.87）d、（9.01±1.88）d、（31.38±3.67）d（P＜0.01）；两组治疗后生理、心理、社会和环境舒适度评分较治疗前升高（P＜0.05），观察组治疗后生理评分（18.74±3.04）分、心理评分（31.88±3.54）分、社会评分（27.74±3.68）分和环境舒适度评分（18.26±2.74）分高于对照组（14.28±2.57）分、（23.69±3.28）分、（22.38±3.19）分、（15.64±2.47）分（P＜0.05）；两组治疗后呼吸症状、活动受限和疾病影响评分较治疗前降低（P＜0.05），观察组治疗后呼吸症状评分（37.64±4.21）分、活动受限评分（36.37±4.64）分、疾病影响评分（38.28±4.97）分低于对照组（40.25±4.85）分、（36.37±4.64）分、（44.37±4.58）分（P＜0.05）；观察组住院期间不良事件发生率6.15%低于对照组20.31%（P＜0.05）。

结论

预警机制下全方位无盲点管理模式应用于AECOPD 并RF，缩短住院治疗时间，控制不良事件，提高舒适度、生活质量，具有临床意义。

Objective

To explore the effects of omnidirectional non-blind spot management model under early warning mechanism on hospital stay and occurrence of adverse events in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） complicated with respiratory failure （RF）.

Methods

All of 129 patients with AECOPD and RF admitted to department of the hospital from January 2022 to January 2024 were selected and randomly divided into observation group （n=65） and control group （n=64）by the single-double number method.The control group was given routine management model while the observation group was given omnidirectional non-blind spot management model under early warning mechanism.The differences in treatment time and hospital stay （ICU treatment time，mechanical ventilation time，hospital stay） were compared between the two groups of patients，and the differences in comfort ［Kolcaba General Comfort Questionnaire （GCQ）］ and quality of life ［St George's Respiratory Questionnaire （SGRQ）］ before and after intervention and occurrence of adverse events ［ventilator-associated pneumonia（VAP），ventilator dependence （VD），pipeline blockage，mask leakage，asphyxia］ during hospitalization were analyzed.

Results

The ICU treatment time，mechanical ventilation time and hospital stay with （16.68±2.01） d，（8.28±1.36）d and （29.44±3.95） d in observation group were shorter than （16.68±2.01） d，（8.28±1.36） d and （29.44±3.95） d in control group （P＜0.01）.After intervention，the comfort scores of physiology，psychology，society and environment in the two groups were increased compared with those before intervention （P＜0.05），and after intervention，the physiological score （18.74±3.04），psychological score （31.88±3.54），social score （27.74±3.68） and environmental comfort score （18.26±2.74） in the observation group were higher than those in the control group （14.28±2.57），（23.69±3.28） and （22.38±3.19），（15.64±2.47） （P＜0.05）.The scores of respiratory symptoms，activity limitation and disease impact in the two groups were decreased after intervention compared to before treatment （P＜0.05），and the respiratory symptom score （37.64±4.21），activity limitation score （36.37±4.64） and disease impact score （38.28±4.97） of the observation group after intervention were lower than those of the control group （40.25±4.85），（36.37±4.64） and （44.37±4.58） （P＜0.05）.During hospitalization，the incidence rate of total adverse events in observation group with 6.15% was lower compared with 20.31% in control group （P ＜0.05）.

Conclusion

The application of omnidirectional non-blind spot management model under early warning mechanism in AECOPD with RF is helpful for the treatment progress of patients，and can shorten the hospitalization treatment time，control the occurrence of adverse events，and improve the comfort and quality of life.