院外延伸护理对重叠综合征患者家用无创呼吸机使用效果的影响

Effect of out-of-hospital extended nursing care on the use of home non-invasive ventilator for patients with overlap syndrome

【目的】探讨院外延伸护理对重叠综合征(overlap syndrome,OS)患者家用无创呼吸机使用效果的影响。【方法】选取我院收治的150例OS住院患者,院后均居家使用无创呼吸机治疗,采用随机数字表法分成对照组和研究组,各75例。对照组给予常规出院指导和健康宣教,研究组在上述基础上开展院外延伸护理。比较两组干预前和干预6个月的肺功能指标[第一秒用力呼气量(forced expiratory volume in the first second,FEV1)、第一秒用力呼气量占用力肺活量比重(FEV1/forced expiratory volume,FEV1/FVC)]、多导睡眠监测指标[呼吸暂停低通气指数(apnea hypopnea index,AHI)、睡眠期最低血氧饱和度和最长呼吸暂停时间],并统计两组院后1年的再住院率和生存质量测定量表(Quality of life scale,QOL-BREF)评分。【结果】干预6个月后,研究组FEV1、FEV1/FVC高于对照组,研究组多导睡眠监测指标均优于对照组(P<0.05)。研究组1年再住院率(5.33%)低于对照组(16.00%),QOL-BREF量表评分也明显高于对照组(P<0.05)。【结论】对居家使用无创呼吸机的OS患者开展院外延伸护理,能帮助改善肺功能,纠正睡眠呼吸紊乱和机体缺氧状况,降低再住院率,提高生活质量。

【Objective】To explore the effect of out-of-hospital extended care on the use of non-invasive ventilator for patients with overlap syndrome(OS).【Methods】A total of 150 inpatients with OS who were admitted to our hospital were selected and treated with non-invasive ventilator at home after the hospital.The patients were randomly divided into control group and study group,with 75 cases in each group.The control group was given routine discharge guidance and health education,and the study group carried out out-of-hospital extended nursing on the basis of the above.The pulmonary function indexes[forced expiratory volume in the first second(FEV1),FEV1/forced vital capacity(FEV1/FVC)]and polysomnography monitoring indexes[apnea hypopnea index(AHI),minimum blood oxygen saturation and maximum apnea time during sleep]before and 6 months after intervention were compared between the two groups,and the rehospitalization rate and the quality of life scale(QOL-BREF)in the two groups one year after hospitalization were counted.【Results】After 6 months of intervention,FEV1 and FEV1/FVC in the study group were higher than those in the control group,and the polysomnography monitoring indexes in the study group were better than those in the control group(P<0.05).The 1-year rehospitalization rate of the study group was lower than that of the control group,and the QOL-BREF score was also significantly higher than that of the control group(P<0.05).【Conclusion】Out-of-hospital extended care for OS patients who use non-invasive ventilators at home can help improve lung function,correct sleep disordered breathing and hypoxia,reduce rehospitalization rates and improve quality of life.