慢性阻塞性肺疾病的延续护理效果研究

Extended Care for Patients with Chronic Obstructive Pulmonary Disease

目的观察针对慢性阻塞性肺疾病(COPD)患者实行的延续护理效果。方法选择我院3年来的COPD患者63例作为研究对象,采用分层随机化方法分为观察组(33例)和对照组(30例),观察组患者出院后采用延续护理,对照组患者出院后仅采用一般的随访。对两组患者1个月后进行的6 min步行试验结果进行对比分析。出院后1个月时进行临床指标、功能指标、成本指标及满意度指标的评价比较。结果观察组患者6 min步行试验结果的收缩压(t=2.419,P=0.026)、心率(t=2.530,P=0.021)、血氧饱和度(SPO2)(t=-2.346,P=0.031)、总距离(t=-3.423,P=0.003)、Borg评分(t=4.074,P=0.004)与对照组比较,差异均有统计学意义;观察组患者自我效能量表(CSES)评分总分(t=3.545,P=0.002)及在情绪波动(t=3.221,P=0.003)、体力活动(t=3.256,P=0.002)、环境与温度(t=2.997,P=0.004)方面的得分与对照组比较,差异均有统计学意义;两组患者的复门诊率(χ2=6.995,P=0.010)、复住院率(χ2=7.580,P=0.009)间差异均有统计学意义;两组患者在服务方法 (χ2=7.295,P=0.009)和是否具有帮助(χ2=4.698,P=0.046)方面的满意度差异均有统计学意义。结论延续护理能够有效提高COPD患者的依从性、降低患者的复门诊率和复住院率,达到了减少和避免患者反复住院,延长入院间歇的目的。

Objective To observe the effect of extended care for patients with chronic obstructive pulmonary disease(COPD).Methods A total of 63 COPD patients were divided randomly into groups study(n=33) and control(n=30).Group study were given extended care after discharge,control group given conventional follow-up.The results of 6-minute walking test after 1 month were compared in two group.Clinical parameters,function indexes,cost indicators and satisfaction were evaluated 1 month after discharge.Results By results of 6-minute walking test,there was significant difference between 2 groups in SBP(t=2.419,P=0.026),heart rate(t=2.530,P=0.021),SPO2(t=-2.346,P=0.031),total walking distance(t=-3.423,P=0.003),Borg score(t=4.067,P=0.004).By CSES scores,there was difference in total score(t=3.545,P=0.002),labile mood(t=3.221,P=0.003),physical activity(t=3.256,P=0.002),ambient temperature(t=2.997,P=0.004)between 2 groups.There was difference in clinic revisit rate(χ2=6.995,P=0.010),re-hospitalization rate(χ2=7.580,P=0.009),service method(χ2=7.295,P=0.009),aid(χ2=4.698,P=0.046)between 2 groups.Conclusion Extended care can improve effectively COPD patient′s compliance and reduce the rates of revisits and re-hospitalization,thus to obtain the objective decreasing or avoiding re-hospitalization and prolong their intermittent.