干预管理对慢性阻塞性肺疾病患者生存质量的影响

Health management and quality of life of patients with chronic obstructive pulmonary disease

目的 探讨干预管理对慢性阻塞性肺疾病（COPD）患者生存质量的影响.方法 门诊或病房收治的COPD患者90例,按照就诊顺序随机分为管理组和对照组,对照组给予常规治疗,管理组在常规治疗的基础上纳入管理,为每位患者建立个人健康档案,进行COPD防治知识讲座、戒烟宣传教育、呼吸功能锻炼、用药指导、心理疏导,时间为6个月,测定2组患者入选前后吸炯率、6分钟步行距离（6MWD/m）、圣乔治呼吸问题调查问卷（SGRQ）评分变化.结果 6个月后管理组吸烟率较对照组下降（x2=4.464,P＜0.05）,管理组戒烟率较对照组增高（x2=9.119,P＜0.05）.随访6个月后对照组6MWD/m为（318.7±70.6）m,与入选时相比差异无统计学意义（t=4.84,P=0.024）;管理组6 MWD/m为（372.0±76.3）m,较健康教育管理前增加（t=-7.14,P=0.00）.管理组6个月后呼吸症状、活动受限、疾病影响及SGRQ总评分（45.3±18.1）、（36.8±23.1）、（34.5±21.4）、（40.5±21.3）均较管理前（62.1±21.8）、（53.9±19.7）、（48.6±20.3）、（53.7±18.6）下降（t=6.15、5.18、4.70、5.07,均P＜0.05）;对照组6个月后呼吸症状、活动受限、疾病影响及SGRQ总评分与入选时比较,差异无统计学意义（t=-2.03、-1.24、-4.17、-2.95,均P＞0.05）.结论 对COPD患者干预管理可以降低患者吸烟率、增强患者运动耐力,提高患者生存质量.

Objective To evaluate the impacts of health management on quality of life of patients with chronic obstructive pulmonary disease （COPD）. Methods Ninety COPD in- or out-patients were assigned to two groups according to visit date. The control group was treated with conventional therapy, and the observation group obtained conventional therapy ＋ standard health management for 6 months. Cigarette smoking, 6 MWT/m and The St George＇s Respiratory Questionnaire （SGRQ） were evaluated before and after the intervention. Results At 6 months, the ratio of current cigarette smoking of the observation group was much lower than that at baseline （X2=4.464, P〈0.05）, 6 MWD/m was significantly increased （337.2-＋82.6 vs 372.0-＋76.3, t=-7.14, P=0.00）, and the scores of respiratory symptoms, limitation of motion and influence of disease and total score of SGRQ were significantly reduced （t values were 6.15, 5.18, 4.70 and 5.07, respectively; all P〈0.05）. Conclusion Standard health management could decrease the rate of current cigarette smoking and improve exercise tolerance and the quality of life of COPD patients.