Clinical controlled study on bedside D-dimer levels and predictive nursing in patients with acute exacerbation of chronic obstructive pulmonary disease
慢性阻塞性肺病急性发作期患者床旁D-二聚体水平及预见性护理的临床对照研究

摘要

目的 探讨慢性阻塞性肺病（COPD）急性发作期患者床旁D-二聚体水平的变化及预见性护理对其临床结局的影响。方法 选取2018年1月至2020年12月期间收治的COPD急性发作期患者作为研究对象，根据入院时的床旁D-二聚体水平将患者随机分为观察组和对照组，每组50例。观察组在标准治疗的基础上进行预见性护理干预，对照组仅接受标准治疗。比较两组患者的床旁D-二聚体水平变化、住院时间、病死率和再发率。 结果 观察组患者干预后床旁D-二聚体水平更稳定，与对照组相比差异显著（P<0.05）。观察组的住院时间明显短于对照组，病死率显著低于对照组，再发率明显低于对照组。讨论：床旁D-二聚体是一种血栓形成的标志物，其水平的变化可能与COPD急性发作期的疾病进展和预后有关。结果 通过监测床旁D-二聚体的变化，并实施预见性护理，可以有效降低血栓形成和肺栓塞的风险，缩短住院时间，降低病死率，减少再发率。结论 慢性阻塞性肺病急性发作期患者床旁D-二聚体水平与临床结局密切相关。通过监测床旁D-二聚体水平，并采取预见性护理措施，可以提前识别疾病进展风险，改善临床结局。这一研究结果对于指导护理实践，提高COPD急性发作期患者的护理质量具有重要意义。

Abstract

Objective To explore the changes in bedside D-dimer levels in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and the impact of predictive nursing on their clinical outcomes.
Methods Patients with acute exacerbation of COPD admitted between January 2018 and December 2020 were selected as the study subjects. Based on their bedside D-dimer levels at admission, the patients were randomly divided into an observation group and a control group, with 50 cases in each group. The observation group received predictive nursing intervention on the basis of standard treatment, while the control group only received standard treatment. Compare the changes in bedside D-dimer levels, length of hospital stay, mortality rate, and recurrence rate between two groups of patients.
Results After intervention, the D-dimer levels at the bedside of the observation group patients were more stable, and the difference was significant compared with the control group (P<0.05). The hospitalization time of the observation group was significantly shorter than that of the control group, the mortality rate was significantly lower than that of the control group, and the recurrence rate was significantly lower than that of the control group. Discussion: Bedside D-dimer is a biomarker of thrombosis, and changes in its levels may be associated with disease progression and prognosis during acute exacerbations of COPD. The results of this study showed that monitoring changes in bedside D-dimer levels and implementing proactive care can effectively reduce the risk of thrombosis and pulmonary embolism, shorten hospitalization time, lower mortality rates, and reduce recurrence rates.
Conclusion   Bedside D-dimer levels in patients with acute exacerbation of chronic obstructive pulmonary disease are closely related to clinical outcomes. By monitoring the level of D-dimer at the bedside and taking proactive nursing measures, the risk of disease progression can be identified in advance and clinical outcomes can be improved. This research result is of great significance for guiding nursing practice and improving the quality of care for patients with acute exacerbation of COPD.