早期慢性阻塞性肺疾病社区综合管理实践

Comprehensive management of early chronic obstructive pulmonary diseases in communities

目的探讨早期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)社区综合管理实践效果。方法本院与社区卫生服务中心合作,对本地区户籍居民具备COPD高危人群1091例进行肺功能检查,筛选出早期COPD第Ⅰ、Ⅱ级患者191例,制订有效的社区综合管理方法。3个月后对综合管理前后患者肺功能情况、COPD评估测试(assessment test,CAT)评分及吸烟率情况进行比较。结果综合管理前后患者肺功能第1s用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1与用力肺活量(forced vital capacity,FVC)之比(forced expiratory volume in one second/forced vital capacity,FEV1/FVC)、CAT及吸烟率情况比较,均P<0.05,差异具有统计学意义,综合管理后患者FEV1、FEV1/FVC、CAT及吸烟率情况明显优于综合管理前。结论社区综合管理模式能使早期COPD患者得到有效的治疗与护理,发病率及肺功能下降率明显减少,取得较好的社会与经济效益。

Objective To study the effect of comprehensive management of chronic obstructive pulmonary diseases（COPD）in the communities.Methods One thousand and ninety one residents with high risk of COPD in the communities were involved in the pulmonary function tests conducted by the hospital together with the local community health service centers,191 cases of early COPD screened out at stages of Ⅰ or Ⅱ.The comprehensive management plan was made for the patients.Three months later,the results in their lung function,the score by CAT（COPD Assessment Test）and the smoking rate were compared with the results before the performance.Result The forced expiratory volume in one second（FEV1）and the ratio between forced expiratory volume in one second and forced vital capacity（FEV1/FVC）,the CAT score and the smoking rate after the performance were all significantly better than before the performance（all P 0.05.Conclusion The comprehensive management of early chronic obstructive pulmonary diseases in the communities may make patients accessible to effective early treatment and nursing care so that the morbidity of COPD and the rate of lung function decline are reduced.