老年慢性阻塞性肺疾病患者生活质量调查及干预对策

Survey on Quality of Life of Elderly Patients with Chronic Obstructive Pulmonary Disease and Intervention Strategies

目的调查老年慢性阻塞性肺疾病(COPD)患者的生活质量,分析其影响因素,提出有针对性的干预对策,改善患者生活质量。方法 2015年1—12月采用便利抽样方法抽取宁夏人民医院呼吸科门诊接诊的符合纳入标准的COPD患者150例,采用一般资料问卷、圣乔治呼吸问卷(SGRQ)对患者进行调查,并检测患者营养状况和肺功能分级。采用单因素分析及多元线性回归分析分析老年COPD患者SGRQ评分的影响因素。结果 147例(98.0%)患者完成调查,SGRQ总评分为(41.5±19.9)分。单因素分析显示,家庭人均月收入、纳入医保情况、吸烟状况、职业粉尘烟雾暴露史、病程、过去1年因COPD住院次数、药物治疗、肺康复锻炼情况、营养状况、肺功能分级对SGRQ评分有影响(P<0.05)。多元线性回归分析显示,肺康复锻炼情况、营养状况、肺功能分级是老年COPD患者SGRQ评分的影响因素(t=-4.599、-3.755、18.702,P<0.05)。结论老年COPD患者生活质量不高,肺康复锻炼情况、营养状况、肺功能分级是老年COPD患者生活质量的影响因素,应加强COPD患者营养及肺康复锻炼指导,减缓肺功能下降速度,提高患者生活质量。

Objective To survey the quality of life of elderly patients with chronic obstructive pulmonary disease （COPD）, analyze its influencing factors, put forward targeted intervention measures to improve the quality of life of patients. Methods According to the inclusion criteria, 150 elderly patients with COPD treated in the outpatient of Ningxia People＇s Hospital from January 2015 to December 2015 were selected. The patients were investigated with general information questionnaires and St Georges Respiratory Questionnaire （SGRQ）, and their nutritional status and pulmonary function classification were measured. Influencing factors of SGRQ score for elderly patients with COPD were assessed by univariate and multivariate linear regression analysis. Results A total of 147 （98.0%） patients finished the investigation, whose SGRQ total score was （41.5 ± 19.9） points. Univariate analysis indicated that family per capita monthly income, health insurance, smoking situation, occupational dust or smoke exposure history, disease duration, the number 0f hospitalization due to COPD in last one year, pharmacotherapy, pulmonary rehabilitation exercises, nutritional status and＇ classification of pulmonary function affected SGRQ score （ P 〈 0. 05 ） . Multivariate linear regression analysis indicated that pulmonary rehabilitation exercise, nutritional status and classification of pulmonary function were the influence factors for SGRQ score （ t = - 4. 599, - 3.755, 18. 702, P 〈 0. 05） . Conclusion The quality of life of elderly patients with COPD was not high. The pulmonary rehabilitation exercise, nutritional status and pulmonary function classification were the factors affecting the quality of life of elderly patients with COPD. The patients with COPD should be strengthened with guidance of pulmonary rehabilitation exercises and nutrition to slow down the declination of lung function and imorove qualitv of life of the oatients.