社区干预对稳定期COPD患者实施效果分析

Analysis of the Implementation Effect of Community Intervention on COPD Patients Under Stable Situation

目的分析社区干预对稳定期COPD患者的实施效果,探索COPD患者的社区综合防治模式。方法以打浦桥街道"上海市居民健康档案"调查资料为基础,将158例COPD临床稳定期患者随机分为观察组、对照组,观察组在维持原药物治疗不变的情况下,接受经过专业培训的全科医生的健康指导(饮食、营养及日常行为)、康复治疗(运动处方、呼吸训练)社区综合干预10个月后,比较两组间医嘱遵从性、急性发病率及住院率的差异。结果两组间在医嘱遵从性、急性发病率方面有显著差异(P<0.01),在住院率方面有差异(P<0.05)。结论社区综合干预模式能提高患者遵医行为,提高稳定期COPD患者对疾病的自我管理能力,使患者配合治疗及主动进行康复运动,从而减少疾病急性发病率及住院率,提高患者的生活质量,但是如何在基层医疗机构开展规范、适宜、经济的肺康复治疗,仍是有待研究的课题。

Objective To analyze the effect of community intervention of COPD patients under stable situation,to explore the community comprehensive prevention and control mode of COPD patients.Methods Based on Dapuqiao Street'Shanghai city resident health archives'investigation,158 patients under COPD clinical stabilization period were randomly divided into the observation group and the control group.The observation group maintained the original drug treatment under the condition of invariable,health guidance to accept the professional training of general practitioners(diet,nutrition and daily behavior),rehabilitation(exercise prescription,breathing exercise) intervention after 10 months.The comparison between two groups' adherence,acute morbidity and hospitalization rate was different.Results Between the two groups in terms of adherence,acute exacerbation were significantly different(P < 0.01).There are differences in hospitalization(P < 0.05).Conclusion Community comprehensive intervention can improve the compliance behavior of patients,improve the ability of self-management of the disease in stable COPD patients,patient treatment and rehabilitation exercise,reduce disease acute morbidity and hospitalization rate,and improve the quality of life of patients.But in the basic medical institutions,how to develop standard,suitable and economic lung rehabilitation treatment still needs researching.