基于微信平台的管理模式对轻中度慢阻肺患者的干预效果

Effect of information management mode based on WeChat platform on patients with mild to moderate chronic obstructive pulmonary disease

目的评价基于微信平台的管理模式对轻中度慢性阻塞性肺疾病(简称慢阻肺)的干预效果。方法纳入2019年1月至2020年1月商丘市第一人民医院呼吸科门诊或病房就诊的轻中度慢阻肺患者根据奇偶随机化入组100例, 观察组、对照组各50例。对照组进行常规门诊治疗及健康教育随访, 观察组在对照组同样治疗的基础上进入慢阻肺微信管理群, 应用微信平台进行管理。6个月后比较干预前后两组患者的戒烟情况、吸入药物依从性(MMAS-8)评分、慢阻肺评估测试(CAT)问卷评分, 6 min步行距离(6MWD)和肺功能[第一秒用力呼气容积(FEV1)及FEV1占预计值百分比(FEV1%预计值)等]测定结果。结果观察组46例患者完成干预随访, 对照组35例完成随访, 观察组失访率低于对照组(8%比30%)(P<0.05);干预后观察组戒烟成功率、MMAS-8评分、CAT评分、FEV1及FEV1%预计值均显著高于对照组[82.4%比53.6%、(5.17±1.06)比(4.55±0.94)分, (6.72±4.29)比(9.37±4.54)分, (1.87±0.44)比(1.64±0.41)L, (69.48±10.97)%比(64.46±8.25)%](均P<0.05);观察组6MWD与对照组差异无统计学意义[(401.5±92.3)比(382.9±79.7)m](P>0.05)。结论基于微信平台的管理模式可以提高轻中度慢阻肺患者的戒烟率及用药依从性, 改善患者症状及肺功能。

Objective To evaluate the effect of management mode based on WeChat platform on patients with mild to moderate chronic obstructive pulmonary disease(COPD).Methods A total of 100 patients with mild to moderate COPD treated in the outpatient or ward of the Respiratory Department of Shangqiu First People′s Hospital from January 2019 to January 2020 were included.According to the randomization criteria singular number(observation group,control group),there were 50 cases in each group.The control group received routine outpatient treatment and health education follow-up,the observation group was enrolled into the WeChat management group of COPD based on the same treatment as the control group.Smoking cessation,eight-item Morisky Medication Adherence Scale(MMAS-8)score for inhaled drug compliance,chronic obstructive pulmonary disease assessment test(CAT)questionnaire score,6 min walking distance(6MWD)and lung function[forced expiratory volume in the first second(FEV1)and FEV1%pred]were compared between 2 groups before and after six months intervention.Results After intervention,the intervention follow-up was completed in 46 patients in the observation group and 35 patients in the control group,the rate of loss to follow-up in the observation group was lower than that in the control group(8%vs.30%)(P<0.05);The success rate of smoking cessation,the score of MMAS-8,the score of CAT,the FEV1 and FEV1%pred in the observation group were higher than those in the control group[82.4%vs 53.6%,(5.17±1.06)vs(4.55±0.94)points,(6.72±4.29)vs(9.37±4.54)points,(1.87±0.44)vs(1.64±0.41)L,(69.48±10.97)vs(64.46±8.25)%](all P<0.05).There was no significant difference in 6MWD between the observation group and the control group[(401.5±92.3)vs(382.9±79.7)m](P>0.05).Conclusion Management intervention based on WeChat platform can improve the smoking cessation rate and medication compliance of patients with mild to moderate COPD,so as to reduce the symptoms of dyspnea and delay the decline of pulmonary function.