中重度慢性阻塞性肺疾病患者的自我管理初步探索

Self- management of the Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease

目的：探讨自我管理对中重度慢性阻塞性肺疾病（COPD）患者疗效，以期缩短治疗时间，提高生活质量。方法：选取2013年5月～2014年10月100例中重度慢性阻塞性肺疾病患者为研究对象，分成两组，对照组50例，予常规西医药物治疗，观察组50例，加用自我管理，观察COPD急性发作比率、住院次数、医疗费用、症状控制时间、肺功能、生活质量等变化情况。结果：两组在症状管理、日常生活管理、情绪管理、信息管理、自我效能，COPD急性发作比率、住院次数、医疗费用、症状控制时间比较有统计学意义（P〈0．05）。两组治疗前在肺功能用力肺活量（FVC）、1秒用力呼气容积（FEVl）、FVC／FEVl和生活质量呼吸症状、活动受限、疾病影响上比较差异无统计学意义（P〉0．05）；治疗后和治疗前比较差异有统计学意义（P〈0．05）。而观察组较对照组在治疗后比较则有显著统计学意义（P〈0．05）。结论：自我管理能减轻重度慢性阻塞性肺疾病症状，提高肺功能和生活质量。

OBJECTIVE ： To evaluate the efficacy of the patient self - management of moderate to severe chronic obstructive pul- monary disease （COPD） in order to shorten the treatment time and improve the quality of life. METHODS： From May 2013 -2014 October 100 patients with moderate to severe chronic obstructive pulmonary disease were divided into two groups. The control group （ n = 50） received conventional Western medicine treatment, observation group （ n = 50） accepted the same treatment method, plus self- management. Ratio of COPD exacerbations, hospitalizations, medical expenses, time symptom control, lung function and quality of life changes were observed. RESULTS： There were statiscally difference in two group in symptom management, daily life management, emotional management, information management, self - efficacy, COPD exacerbations ratio, number of hospitaliza- tions, medical expenses and symptom control time （P 〈 0. 05 ）. Before treatment there was no statistically significant difference （ P 〉0. 05） in lung function FVC, FEV1, FVC / FEVI, quality of life of respiratory symptoms, activity limitation and the disease effects ; after treatment there was statistically significant difference （P 〈 0. 05 ）. CONCLUSIONS ： Self - management can reduce the symptoms of moderate to severe chronic obstructive pulmonary disease and improve lung function and quality of life.