延续护理结合心理康复在慢性阻塞性肺疾病合并抑郁症患者中的应用价值

Application value of continuous nursing combined with psychological rehabilitation in patients with chronic obstructive pulmonary disease and depression

目的探讨对慢性阻塞性肺疾病(COPD)伴抑郁症患者实施延续护理结合心理康复的效果。方法以2018年5月至2021年5月聊城市第四人民医院收治的86例COPD合并抑郁症患者为研究对象,根据动态随机分组法将所有患者分为2组,即对照组(43例)和观察组(43例)。对照组患者给予延续护理,观察组患者实施延续护理结合心理康复。比较2组患者在入院时和出院时的第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC、pH值、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、COPD自我评估测试(CAT)和汉密尔顿抑郁量表评分(HAMD),以及入院时和出院6个月后的圣乔治呼吸问卷(SGRQ)评分。结果出院时,2组的HAMD、CAT得分均低于入院时(P均<0.05),且观察组的上述量表得分均低于对照组(P均<0.05);2组的FEV_(1)、FVC和FEV_(1)/FVC均高于入院时(P均<0.05),且观察组均高于对照组(P均<0.05);2组的PaO_(2)水平、pH值均高于入院时,PaCO_(2)水平均低于入院时(P均<0.05),且观察组的上述指标均优于对照组(P均<0.05)。出院6个月后,2组的SGRQ各项评分均低于入院时(P均<0.05),且观察组的SGRQ各项评分均低于对照组(P均<0.05)。结论延续护理结合心理康复在COPD伴抑郁症患者的护理中应用效果显著,能够有效改善患者的肺功能,减轻其消极情绪,提高其生活质量。

Objective To explore the effect of continuous nursing combined with psychological rehabilitation on the chronic obstructive pulmonary disease(COPD)patients with depression.Methods A total of 86 COPD patients with depression who were admitted to Liaocheng Fourth People􀆳s Hospital from May 2018 to May 2021 were enrolled.All patients were divided into two groups through dynamic randomization:a control group(43 cases)and an observation group(43 cases).The patients in the control group were given continuous nursing,and the patients in the observation group were given continuous nursing combined with psychological rehabilitation.The forced expiratory volume in 1 second(FEV_(1)),forced vital capacity(FVC),FEV_(1)/FVC,pH value,arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2)),COPD Assessment Test(CAT),and Hamilton Depression Rating Scale(HAMD)scores at admission and discharge,as well as the St.George􀆳s Respiratory Questionnaire(SGRQ)scores at admission and 6 months after discharge,were compared between the two groups.Results At discharge,the scores of HAMD and CAT in the two groups were lower than those at admission(all P<0.05),and the scores of the above scales in the observation group were lower than those in the control group(both P<0.05).The FEV_(1),FVC,FEV_(1)/FVC values in the two groups were higher than those at admission(all P<0.05),and the above values in the observation group were higher than those in the control group(all P<0.05).The PaO_(2)level and pH value in the two groups were higher than those at admission,and the PaCO_(2)level was lower than that at admission(all P<0.05).The above indicators in the observation group were better than those in the control group(all P<0.05).At 6 months after discharge,the scores of various items of the SGRQ in the two groups were lower than those at admission(all P<0.05),and the SGRQ scores of the observation group were lower than those of the control group(all P<0.05).Conclusion Continuous nursing combined with psychological rehabilitation has a significant effect on the nursing of COPD patients with depression,which can effectively improve their pulmonary function,reduce their negative emotions,and improve their quality of life.