六字诀呼吸操在社区老年患者COPD并开腹术后延续护理的应用

Application of Six-Character Formula Respiratory Training in Community Continuous Nursing for Abdominal Surgery Elderly Patients with COPD

目的:探讨六字诀呼吸操在社区老年患者COPD并开腹术后延续护理的应用与效果。方法:选择2015年1月至12月在湖南省旺旺医院普外科就诊的COPD并开腹手术老年患者60例,按照随机数字表法分为治疗组和对照组各30例。2组患者均给予健康教育和医院-社区合作式的延续护理模式。治疗组给予六字诀呼吸操训练,对照组进行常规缩唇腹式呼吸。2组患者分别于干预前,干预1、3、6个月后进行活动耐力(6MWT)、生活质量(CAT)及干预6个月后早期预后各项指标的评估。结果:与基线相比,经过6个月的干预后,治疗组6MWT、CAT明显增加,差异有统计学意义(P=0.000);对照组6MWT提高(P=0.000)。组间比较,干预3个月、6个月后的6MWT及干预6个月后的CAT,治疗组优于对照组,差异有统计学意义(P=0.000)。结论:六字诀呼吸操应用于社区老年患者COPD并开腹术后延续护理可显著改善老年患者的活动耐力及生活质量,但对早期预后效果的改善尚不明显。与缩唇腹式呼吸相比,六字诀呼吸操促进患者全面康复的优势随干预周期的延长更加凸显。因此,六字诀呼吸操可作为社区老年患者COPD并开腹术后居家延续护理的有效康复手段。

Objective： To explore the application and effect of six-character formula respiratory training in community continuous nursing for abdominal surgery elderly patients with COPD. Methods： In the department of general surgery of Wangwang Hospital of Hn＇nan Province, 60 cases abdominal surgery elderly patients with COPD were selected from March to December 2015. According to the random number table method, the pa- tients were divided into the treatment and control groups, 30 cases in each. The patients in both groups were given routine health education and Hospital-Community cooperation＇s continued nursing mode. Patients in the treatment group were given six-character formula respiratory training, while traditional pursed lips and abdominal breathing exercise in the control group. The 6MWT and CAT to evaluate patients＂ exercise endurance and life quality were measured in two groups before and after 1, 3 and 6 months of intervention respectively, and indexes about early prognosis after 6 months＂ intervention. Results： Comparing baseline, after six months＂ intervention, the 6MWT and CAT increased in treatment group, with statistical difference （P=0.000）; the 6MWT increased in control group （P=0.000）; the treatment group showed higher 6 MWT after 3 and 6 months＂ intervention, as well as higher CAT after 6 months intervention than the control group, with statistical significant differ- ence （P=0.000）. Conclusion： Six-character formula respiratory training apply to community continuous nursing for abdominal surgery elderly patients with COPD can significantly improve the elderly＇s exercise endurance and life quality, but referring the improvement effect of early prognosis is unclear. Comparing with pursed lips and abdominal breathing exercise, six-character formula respiratory training could promote patients＇ comprehensive rehabilitation with more highlight advantages along with the extension of training cycle. Therefore, six-character formula respiratory training can serve as a good rehabilitation training method in community continuous nursing for abdominal surgery elderly patients with COPD training at home.