过渡期护理模式对COPD患者居家无创正压通气的干预效果

The effects of transitional care model for COPD patients receiving home noninvasive positive pressure ventilation

目的探讨过渡期护理模式(TCM)对慢性阻塞性肺病(COPD)合并Ⅱ型呼吸衰竭行居家无创正压通气患者肺通气功能、症状改善、生活质量、呼吸机管理等方面的影响。方法选择63例COPD合并Ⅱ型呼吸衰竭需要行居家无创正压通气的患者,分为试验组30例和对照组33例,试验组给予定时电话随访指导、定时家庭访视干预和随时咨询服务的过渡期护理,对照组仅提供出院后电话随访1次和随时咨询服务,总护理时间为6个月。比较两组的肺通气功能、动脉血气分析、生活质量状况、呼吸机管理等指标。结果试验组在肺通气功能、动脉血氧分压、动脉血二氧化碳分压、生活质量、呼吸机管理等方面优于对照组,差异有统计学意义(P<0.05或P<0.01)。结论运用过渡期护理模式为居家无创正压通气的患者提供过渡期护理服务,可维持患者肺功能的稳定、增加患者的舒适度、提高患者的生活质量、降低再住院率。

Objective To evaluate the effects of transitional 43care model（TCM） on lung ventilation function,improvement in symptoms,quality of life,and management of ventilator in patients with chronic obstructive pulmonary disease （COPD） and type Ⅱ respiratory failure who require home noninvasive positive pressure ventilation. Methods Sixty-three patients with COPD and type Ⅱ respiratory failure who require home noninvasive positive pressure ventilation were selected and assigned into two groups,i.e.,the transitional care group （n=30）and the routine care group （n=33）. The transitional care group received guideline on regular phone calls,regular following-up home visits,and anytime consulting service,while the routine group received only one time following-up visit by phone call after discharge and anytime consulting service. Total treatment time was 6 months for each group. Then the following metrics were compared： the data of lung ventilation function,arterial blood gas analysis,quality of life, and management of ventilator＇.＇ Results The transitional care group outperformed the routine care group in terms of improved value in the lung ventilation function,PaO2,PaCO2,quality of life,and management of ventilator （P〈0.05 or P〈0.01）. Conclusion Providing transitional care services with TCM for patients,who require home noninvasive positive pressure ventilation,can improve the pulmonary function,increase the comfort level,improve the quality of life,and reduce rehospitalization rates.