戒烟干预对慢性阻塞性肺疾病患者近期呼吸道症状的影响

Effect of Smoking Cessation Intervention on Short Term Respiratory Clinical Symptoms in Patients with Chronic Obstructive Pulmonary Disease

目的:探讨以护士为主导的戒烟群组干预对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者近期呼吸道症状的影响。方法:选择经过简单口头建议后产生戒烟意愿的稳定期COPD吸烟患者33例,对其进行每周1次的群组干预,直至戒断后1个月。干预内容包括由护理人员普及疾病知识、宣教戒烟技巧、辅导督促、同伴激励、吸入药物应用指导等活动,同时由护士记录患者的吸烟情况、咳嗽、咳痰和呼吸困难情况,并以COPD评估测试(COPD assessment test,CAT)量表和改良的英国医学研究委员会呼吸困难量表(modified British Medical Research Council,mMRC)评价患者戒烟前后的呼吸道症状和生活质量。结果:33例患者中,慢性咳嗽者25例(75%)、慢性咳痰者18例(54.5%)、呼吸困难者21例(63.6%)、维持戒烟者28例(84.8%)。戒烟后1个月CAT评分和mMRC均显著低于戒烟前(P<0.01)。研究期间未观察到不良反应的发生。结论:以护士为主导的戒烟群组干预在COPD患者中能够达到较高的戒断率,戒烟后短期内即可改善患者的呼吸道状况及生活质量。

Objective： To investigate the effect of nurse-led group intervention of smoking on short term respiratory clinical symptoms in patients with chronic obstructive pulmonary disease （COPD）. Methods：Thirty-three smoking patients with stable COPD who intended to give up smoking after a brief verbal advice were recruited into the study. Weekly group intervention was performed for every participants till one month after cessation. The contents of intervention included teaching knowledge deliv- ered by the nursing staff, counseling cessation skills, encouraging and supervising, companion encouragement, and guide on in- haled medications. Smoking status, cough, sputum and dyspnea were recorded, and symptoms and quality of life were evalua- ted by COPD assessment test （CAT） and the modified Medical Research Council （mMRC） scale during the study period. Results： Twenty-five subjects （75%） reported chronic cough, 18（54.5%） had chronic sputum, and 21 （63.6%） had dyspnea, 28 （84.8%） successfully maintained smoking cessation. One month after cessation, the CAT score and mMRC score were both significantly lower than before cessation （P〈0.01）. Conclusions： Nurse-led smoking cessation group intervention in patients with COPD can achieve a high cessation rate. Respiratory symptoms and quality of life can be improved even after a short peri od of cessation.