家庭访视联合电话随访干预对COPD-OSAHS患者家庭无创正压通气治疗的影响

Effect of home visit and telephone follow-up intervention on COPD-OSAHS patients treated with CPAP

目的探讨家庭访视联合电话随访干预模式对慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停低通气综合征(chronic obstructive pulmonary disease complicated with obstructive sleep apnea hypopnea syndrome,COPD-OSAHS)患者使用家庭持续正压通气(continuous positive airway pressure ventilation,CPAP)治疗的效果。方法选择2015年1月—2016年12月收治于东南大学医学院附属南京胸科医院使用CPAP治疗的COPD-OSAHS患者59例,随机分为观察组26例和对照组33例。对照组出院时进行常规健康宣教;观察组在此基础上进行出院后随访,随访方式为家庭访视联合电话随访,随访时间为出院后1周进行家庭访视,随后每月进行1次电话随访,持续6个月。随访内容包括指导患者培养良好的生活习惯;重点检查家庭氧疗使用情况,强调各项注意事项等。两组患者出院6个月后,安排来院进行呼吸机使用情况、多导睡眠监测和肺功能检查分析。结果观察组对呼吸机的使用情况、多导睡眠监测情况及肺功能情况均优于对照组,差异均有统计学意义(P<0.05)。结论家庭访视联合电话随访干预模式能有效提高COPD-OSAHS患者使用CPAP治疗的依从性,改善患者呼吸状态,提高生活质量。

Objective To explore the influence of home visit combined with telephone follow-up intervention on the use of home noninvasive continuous positive airway pressure ventilation（ CPAP） in the patients with chronic obstructive pulmonary disease complicated with obstructive sleep apnea hypopnea syndrome（ COPD-OSAHS）.Methods A total of 59 cases in Nanjing Chest Hospital,Medical School of Southeast University were selected from January 2015 to December 2016. They were randomly divided into the experimental group（ n = 26） and control group（ n = 33）. The control group was given routine education,while the experimental group was given additional follow-up for 6 months,including home visit one week after hospital discharge followed by telephone follow-up once every month. The follow-up aimed to guide the patients to cultivate good living habits,focusing on the use of oxygen therapy at home. Results The experimental group had better use of CPAP,lower apnea hypopnea index（ AHI） and better lung functions than the control group. Conclusion Home visit and telephone follow-up intervention could effectively improve the CPAP use compliance in COPD-OSAHS patients,improve their respiratory status and quality of life.