责任制医护协作模式下排痰训练管理对老年AECOPD患者呼吸困难缓解效果及睡眠质量的影响

Effects of Expectoration Training Management under Responsibility Doctor-Nurse Collaboration Model on Dyspnea Relief and Sleep Quality in Elderly Patients with AECOPD

目的:探究责任制医护协作模式下排痰训练管理对老年慢性阻塞性肺疾病急性加重期(AECOPD)患者呼吸困难缓解效果及睡眠质量的影响。方法:选取2019年1月至2021年8月宿迁市第一人民医院收治的76例老年AECOPD患者作为研究对象,以2020年8月开始实施责任制医护协作模式下排痰训练管理为时间节点,将2019年1月至2020年7月实施常规护理干预模式的37例患者为对照组;2020年8月至2021年8月实施责任制医护协作模式下排痰训练管理的39例患者分为观察组。比较干预1周后2组患者吸痰频次、呼吸困难指数(mMRC)、第1秒用力呼气容积(FEV1)占用力肺活量(FVC)比值(FEV1/FVC)、FEV1占预计肺活量比值(FEV1/Pre)、匹兹堡睡眠质量指数(PSQI)评分情况。结果:干预1周后,观察组吸痰频次及mMRC水平明显低于对照组(P<0.05);观察组FEV1/FVC、FEV1/Pre水平均明显高于对照组(P<0.05);观察组PSQI评分显著低于对照组(P<0.05)。结论:责任制医护协作模式下排痰训练管理可有效缓解老年AECOPD患者呼吸困难程度,促进患者排痰,改善其肺功能和睡眠质量,值得临床推广使用。

Objective:To explore the effect of sputum removal training management under the collaborative mode of responsibility medical care on the relief effect of dyspnea and sleep quality in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 76 elderly patients with AECOPD admitted to Suqian First People′s Hospital of from January 2019 to August 2021 were selected as the research objects.The sputum discharge training management under the collaborative mode of responsibility medical care was implemented in August 2020 as the time node,and 37 patients with routine nursing intervention mode from January 2019 to July 2020 were selected as the control group.From August 2020 to August 2021,39 patients were selected as observation group.Sputum aspiration frequency,dyspnea index(mMRC),ratio of forced expiratory volume(FEV1)to forced vital capacity(FEV1/FVC),ratio of FEV1 to expected vital capacity(FEV1/Pre)and score of Pittsburgh Sleep Quality Index(PSQI)in 2 groups were compared 1 week after intervention.Results:After 1 week of intervention,sputum aspiration frequency and mMRC level in the observation group were significantly lower than those in the control group(P<0.05).The levels of FEV1/FVC and FEV1/Pre in observation group were significantly higher than those in control group(P<0.05).PSQI score of observation group was significantly lower than that of control group(P<0.05).Conclusion:Sputum discharge training management under the collaborative mode of responsibility medical care can effectively relieve dyspnea degree of elderly patients with AECOPD,promote sputum discharge,improve lung function and sleep quality,which is worthy of clinical application.