个性化肺康复结合多形式健康教育在COPD伴慢性呼吸衰竭患者中的效果

Effect of individualized pulmonary rehabilitation combined with diverse health educationon patients with COPD and chronic respiratory failure

目的 评价个性化肺康复结合多形式健康教育策略在慢性阻塞性肺疾病(COPD)伴慢性呼吸衰竭患者中的应用效果。方法 纳入2019年11月至2021年10月徐州医科大学附属医院呼吸与危重症医学科收治的98例COPD伴慢性呼吸衰竭患者进行研究,按照随机数字表法分为观察组和对照组,各49例。2组患者均接受个性化肺康复管理,对照组在此基础上给予常规教育,观察组在对照组入院宣教的基础上结合多形式健康教育。比较干预前后2组患者的血气分析指标、肺康复效果和生活质量。结果 干预后,2组的动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))和酸碱度(pH值)均较干预前有所改善(P均<0.05),且观察组的血气分析指标均优于对照组(P均<0.05);2组的第1秒用力呼气容积占预计值的百分比(FEV_(1)%pred)、6 min步行试验(6MWD)和Borg量表评分均较干预前有所改善(P均<0.05),且观察组的FEV_1%pred和6MWD均大于对照组,Borg评分低于对照组(P均<0.05);2组的圣乔治呼吸问卷(SGRQ)各部分评分以及总分均较干预前有所下降(P均<0.05),且观察组的活动部分、症状部分、影响部分及总分均低于对照组(P均<0.05)。结论 个性化肺康复结合多形式健康教育策略能够明显改善COPD伴慢性呼吸衰竭患者的呼吸功能,提高肺康复效果及生活质量。

Objective To evaluate the application effect of individualized pulmonary rehabilitation combined with diverse health education in the patients with chronic obstructive pulmonary disease(COPD)and chronic respiratory failure.Methods From November 2019 to October 2021,98 COPD patients with chronic respiratory failure admitted to the Department of Respiratory and Critical Care Medical at the Affiliated Hospital of Xuzhou Medical University were included in the study.They were divided into the observation group and the control group by using a random number table,with 49 patients in each group.Both groups were given individualized pulmonary rehabilitation management.The control group was additionally given routine health education,and the observation group was additionally given diverse health education and routine admission education.The blood gas parameters,pulmonary rehabilitation effect,and quality of life before and after the intervention were compared between the two groups.Results After the intervention,the arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),and pH value in both groups were improved compared with those before the intervention(all P<0.05),and the blood gas parameters in the observation group were better than those in the control group(all P<0.05).The forced expiratory volume in 1 second percent predicted(FEV_(1)%pred),6-min walking test(6MWD),and Borg Scale score in both groups were improved compared with those before the intervention(all P<0.05).The FEV1%pred and 6MWD in the observation group were greater than those in the control group,and the Borg Scale score was lower than that in the control group(all P<0.05).The item scores and total score of the St.George􀆳s Respiratory Questionnaire(SGRQ)in both groups were lower than those before the intervention(all P<0.05),and the scores of activities,symptoms,impact and total score in the observation group were lower than those in the control group(all P<0.05).Conclusion Individualized pulmonary rehabilitation combined with diverse health education can significantly improve the respiratory function,pulmonary rehabilitation effect,and quality of life of COPD patients with chronic respiratory failure.