责任制整体护理在COPD患者肺康复中的应用

Application of accountability overall care on pulmonary rehabilitation of patients with chronic obstructive pulmonary disease

目的探讨责任制整体护理在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者肺康复治疗中的作用。方法选取常规护理的COPD患者100例为对照组,责任制整体护理的COPD患者100例为试验组。比较半年后两组患者肺功能、呼吸困难严重程度分级评分(medical research council dyspnea scale,MRC)、6分钟步行距离(6 minutes walking distance,6MWT)。应用SPSS 18.0统计软件分析数据。结果 (1)对照组实施常规护理6个月后第一秒用力呼气量(forced expiratory volume in first second,FEV1)、FEV1与用力肺活量(forced vital capacity,FVC)的比值(FEV1/FVC)、MRC评分、6MWT与入院时比较,差异有统计学意义(t=6.348,P=0.012;t=15.300,P=0.001;t=-10.270,P=0.017;t=-13.040,P<0.001);试验组实施责任制整体护理6个月后FEV1、FEV1/FVC、MRC评分、6MWT与入院时比较,差异有统计学意义(t=8.834,P<0.001;t=-11.830,P<0.001;t=16.010,P=0.022;t=-17.840,P<0.001)。(2)入院时,试验组与对照组的肺功能相关指标FEV1和FEV1/FVC、MRC评分、6MWT比较,差异无统计学意义。治疗6个月后,试验组与对照组比较FEV1、FEV1/FVC、6MWT升高,MRC评分降低,差异有统计学意义(t=7.439,P<0.001;t=10.183,P<0.001;t=15.972,P=0.002;t=12.316,P=0.013)。结论责任制整体护理有利于改善COPD患者肺功能,提高患者的生活质量。

Objective To explore the effect of accountability overall care on the pulmonary rehabilitation of patients with chronic obstructive pulmonary disease（COPD）. Methods 100 patients with COPD who accepted conventional care were assigned to the control group, whereas 100 patients with COPD who accepted accountability overall care were grouped into the experimental group. After 6 months, the results of lung function, medical research council dyspnea scale（MRC） and 6 minutes walking distance（6MWT） were tested and compared between both groups. SPSS 18.0 was applied for data analysis. Results（1） In the control group, levels of FEV1, FEV1/FVC, MRC and 6MWT showed statistically significant differences before and after the conventional care（t=6.348,P=0.012;t=15.300,P=0.001;t=-10.270,P=0.017;t=-13.040,P〈0.001） and within the experimental group levels of FEV1, FEV1/FVC, MRC and 6MWT showed statistically significant differences before and after the accountability overall care（t=8.834,P〈0.001;t=-11.830,P〈0.001;t=16.010,P=0.022;t=-17.840,P〈0.001）.（2）In terms of levels of lung function, MRC and 6MWT at admission, there was no statistically significant difference between two groups; after 6 months of treatment, levels of FEV1, FEV1/FVC and 6MWT were increased and MRC was reduced in experimental group compared to the control group.There were statistically significant differences between two groups（t=7.439,P〈0.001;t=10.183,P〈0.001;t=15.972,P=0.002;t=12.316,P=0.013）. Conclusions Accountability overall care contributes to the improvement of lung function in patients with CPOD and increases their quality of life.