医院-家庭延续管理对慢性阻塞性肺疾病患者未来风险影响的评估

Evaluation of the impact of hospital-family continuing nursing on future risks of COPD

目的评估医院-家庭延续管理(护理)对慢性阻塞性肺疾病(Chronic obstructive pulmonary disease)未来风险的影响,以期延缓病程的进展。方法募集安徽省某三级甲等医院呼吸内科确诊慢阻肺患者85例,根据患者意愿分为对照组43例和观察组42例。对照组行常规出院健康指导,观察组采用医院-家庭延续护理方案进行指导,分别于患者出院当天、1周、1个月、3个月、6个月、12个月进行慢阻肺评估测试(CAT)问卷调查,同时随访12个月中急性加重及再次住院次数,并进行组间比较。结果与对照组相比较,出院当天、1周、1个月、3个月观察组CAT评分未见统计学差异(P>0.05),6个月观察组CAT评分(19.31±3.84)显著低于对照组(22.51±3.55)(P<0.05),12个月观察组CAT评分(19.38±3.44)显著低于对照组(23.23±4.71)(P<0.05)。观察组患者年平均急性加重次数(0.12±0.40)显著低于对照组(0.35±0.61)(P<0.05),观察组患者年平均再入院次数(0.10±0.30)显著低于对照组(0.19±0.39)(P<0.05)。结论医院-家庭延续护理可降低慢阻肺患者的未来风险,延缓慢阻肺的发展进程。

Objective To explore the impact of hospital-family continuing nursing on future risks of COPD in or- der to delay the progression. Methods 85 eligible patients with COPD were divided into the control group （ n = 43 ） and the observation group （ n = 42） according to their will. Routine care and discharge guidance were provided for the control group, while continued nursing schedule was carried out on the observation group. Their CAT scores were re- corded on the day, 1 week, 1 month, 3 months, 6 months and 12 months after discharge, and the exacerbation rate and readmission frequency within a year were compared between the two groups. Results There was no difference in CAT scores in on the day, 1 week, 1 month or 3 months after discharge between the two groups （ P 〉 0. 05 ）. The CAT score in 6 months were 19. 31 ±3.84 vs 22. 51 ±3.55 6 months after discharge and 19. 38 ±3.44 vs 23.23±4.71 12 months after discharge respectively in the observation group and in the control group （ P 〈 0. 05 ）. The exac- erbation rate was 0. 12 ±0. 40 in the observation group and 0. 35 ±0. 61 in the control group （P 〈0. 05）. The re-ad- mission frequency was 0. 10 ±0. 30 in the observation group and 0. 19 ±0. 39 in the control group （P 〈0. 05）. Con- clusion Hospital-family continuing nursing could reduce future risks and delay the progression in patients with COPD.