家庭氧疗分级管理在老年慢性阻塞性肺疾病稳定期患者中的应用

Application of graded management of home oxygen therapy in elderly patients with stable chronic obstructive pulmonary disease

目的探讨家庭氧疗分级管理在老年慢性阻塞性肺疾病(COPD)稳定期患者中的应用价值。方法选取2017年10月~2018年12月联勤保障部队第九〇〇医院收治的老年COPD稳定期患者82例为研究对象,按照随机数字表法分为对照组(41例)和观察组(41例)。对照组给予常规干预,观察组在对照组基础上给予家庭氧疗分级管理。比较两组患者干预期间急性发作及住院情况,干预前后第一秒用力呼气容积(FEV_(1))、FEV_(1)/用力肺活量(FVC)、血气分析动脉血氧含量(PaO_(2)),动脉血二氧化碳含量(PaCO_(2))。结果观察组干预期间急性发作次数及住院次数均少于对照组,差异有统计学意义(P<0.05)。干预后两组FEV_(1)、FEV_(1)/FVC、PaO_(2)均高于干预前,PaCO_(2)低于干预前,且干预后观察组FEV_(1)、FEV_(1)/FVC、PaO_(2)均高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。结论家庭氧疗分级管理可以减少老年COPD稳定期患者疾病急性发作及住院次数,改善肺功能及缺氧,降低血二氧化碳含量。

Objective To investigate the application value of home oxygen therapy graded management in elderly patients with chronic obstructive pulmonary disease(COPD)at stable stage.Methods A total of 82 elderly patients with COPD in stable stage admitted to the Joint Logistics Support Force No.900 Hospital Putian Medical District from October 2017 to December 2018 were selected as the research subjects,and divided into the control group(41 cases)and the observation group(41 cases)according to random number table method.The control group received routine intervention,the observation group was given an intervention mode of family oxygen therapy hierarchical management on the basis of the control group.Acute attack and hospitalization during the intervention,forced expiratory volume in the first second(FEV_(1)),FEV_(1)/forced vital capacity(FVC),and blood gas analysis of arterial oxygen content(PaO_(2))and arterial carbon dioxide content(PaCO_(2))were compared between the two groups.Results The times of acute attacks and hospitalizations in the observation group were less than those in the control group during the intervention period,and the differences were statistically significant(P<0.05).After intervention,FEV_(1),FEV_(1)/FVC and PaO_(2) in both groups were higher than those before intervention,and PaCO_(2) was lower than that before intervention,and FEV_(1),FEV_(1)/FVC and PaO_(2) in the observation group were higher than those in the control group,and PaCO_(2) was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion The hierarchical management of home oxygen therapy can reduce the number of acute attacks and hospitalizations of elderly patients with stable COPD,improve lung function and hypoxia,and reduce the content of blood carbon dioxide.