慢阻肺呼吸体操对老年慢阻肺患者肺功能及康复护理效果的影响分析

Analysis of the effect of COPD breathing exercises on the pulmonary function of elderly patients with COPD and the effect of rehabilitation nursing

目的探讨和分析慢阻肺呼吸体操锻炼对老年慢性阻塞性肺疾病患者肺功能康复及生存质量的影响。方法本院呼吸科2018年1月至2021年4月收治64例65岁以上的肺功能中度稳定期老年慢阻肺患者,随机分为对照组和观察组,每组32例。住院期间,对照组给予呼吸科常规护理及呼吸体操锻炼口头指导,观察组在对照组基础上每天带领患者进行慢阻肺呼吸体操锻炼1h,出院后通过微信跟踪管理。对比两组出院前及出院后24周的呼吸功能锻炼依从性、肺功能(监测指标包括FEV1、FVC及MEF)及生活质量(WHOQOL-BREF)。结果两组出院前的肺功能FEV1、FVC、MEF系列指标水平及生存质量比较无明显差异(P>0.05),但两组的呼吸体操锻炼依从率在出院前后均差异明显(P<0.05);出院后24周,观察组呼吸功能锻炼依从率、FEV1、FVC、MEF指标水平及WHOQOL-BREF各维度评分和总分均显著高于对照组(P<0.001)。结论通过对老年慢阻肺患者住院期间慢阻肺呼吸体操的指导干预,以及出院后微信跟踪管理,能明显提高患者呼吸功能锻炼的依从性,显著改善其肺功能及生活质量。

Objective:To explore and analyze the effects of COPD breathing exercises on pulmonary function rehabilitation and quality of life in elderly patients with chronic obstructive pulmonary emphysema.Methods:From January 2019 to April 2021,64 elderly patients with chronic obstructive pulmonary disease over 65 years old with moderately stable lung function in the Department of Respiratory Diseases of our hospital were randomly divided into control group and observation group,with 32 cases in each group.During the hospitalization period,the control group was given routine care in the respiratory department and oral instruction of breathing exercises.The observation group led the patients to perform COPD breathing exercises for 1 hour per day on the basis of the control group.After discharge,they were tracked and managed through WeChat.The respiratory function exercise compliance,lung function(monitoring indicators including FEV1,FVC and MEF)and quality of life(WHOQOL-BREF)were compared between the two groups before discharge and 24 weeks after discharge.Results:There was no significant difference in lung function FEV1,FVC,MEF series index levels and quality of life between the two groups before discharge from the hospital(P>0.05),but there were significant differences in the respiratory gymnastics compliance rate of the two groups before and after discharge(P<0.05);24 weeks after discharge,the observation group's respiratory function exercise compliance rate,FEV1,FVC,MEF index levels,and WHOQOL-BREF dimension scores and total scores were significantly higher than those of the control group(P<0.001).Conclusion:Through the guidance and intervention of COPD breathing exercises for elderly patients with chronic obstructive pulmonary disease during hospitalization,and WeChat follow-up management after discharge,it can significantly improve the compliance of patients with exercise of respiratory function and significantly improve their lung function and quality of life.