慢性阻塞性肺疾病社区“防管控”一体化体系建设及效果评价

Construction and effect evaluation of"prevention,management and control"integrated system of chronic obstructive pulmonary disease in community

目的探究慢性阻塞性肺疾病社区“防管控”一体化体系建设及效果。方法选取2021年2月至2022年1月福建省老年医院在福州市部分社区通过便携式肺功能仪检测筛查出的150例慢性阻塞性肺疾病患者作为研究对象,按照随机数字表法将其分为观察组(75例)与对照组(75例)。对照组患者采用常规管理方法,观察组患者采用社区“防管控”管理方法。比较两组患者的活动呼吸情况、自我干预能力、肺功能、焦虑和抑郁情况以及生活质量。结果观察组患者干预后的呼吸困难评分、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分低于对照组,差异有统计学意义(P<0.05);两组患者干预后的呼吸困难评分、SAS评分和SDS评分均低于本组干预前,差异有统计学意义(P<0.05);观察组患者干预后的自我护理能力测定量表(ESCA)评分、第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC水平和世界卫生组织生活质量评估简表(WHOQOL-BREF)评分高于对照组,差异有统计学意义(P<0.05);两组患者干预后的ESCA评分、FEV_(1)、FVC、FEV_(1)/FVC水平和WHOQOL-BREF总分均高于本组干预前,差异有统计学意义(P<0.05);两组患者干预1、3个月时的WHOQOL-BREF评分均高于本组干预前,干预3个月时的WHOQOL-BREF评分均高于本组干预1个月时,差异有统计学意义(P<0.05);观察组干预1、3个月时的WHOQOL-BREF评分均高于同时刻对照组,差异有统计学意义(P<0.05)。结论对于慢性阻塞性肺疾病患者而言,为其建立社区防管控一体化管理体系,可延缓病程进展,提高生活质量,并改善不良情绪,临床价值较高。

Objective To explore the construction and effect of community"prevention,management and control"integrated system of chronic obstructive pulmonary disease in community.Methods A total of 150 patients with chronic obstructive pulmonary disease screened by portable pulmonary function instrument in some communities of Fuzhou by Fujian Provincial Geriatric Hospital from February 2021 to January 2022 were selected as the research objects.According to the random number table method,they were divided into observation group(75 cases)and control group(75 cases).Patients in the control group were treated with routine management methods,while patients in the observation group were treated with community"prevention,management and control"method.The active breathing,self-intervention ability,lung function,anxiety and depression and quality of life were compared between the two groups.Results The dyspnea score,self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores of the observation group after intervention were lower than those of the control group,and the differences were statistically significant(P<0.05).The dyspnea scores,SAS scores and SDS scores of the two groups after intervention were lower than those before intervention,and the differences were statistically significant(P<0.05).The exercise of self-care agency scale(ESCA)score,forced expiratory volume in the first second(FEV_(1)),forced vital capacity(FVC),FEV_(1)/FVC level and World Health Organization quality of life scale(WHOQOL-BREF)score of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).The ESCA scores,FEV_(1),FVC,FEV_(1)/FVC levels and WHOQOL-BREF total scores of the two groups after intervention were higher than those before intervention,and the differences were statistically significant(P<0.05).The WHOQOL-BREF scores of the two groups at 1 and 3 months after intervention were higher than those before intervention,and the WHOQOL-BREF scores at 3 months after intervention were higher than those at 1 month after intervention,and the differences were statistically significant(P<0.05).The WHOQOL-BREF scores of the observation group at 1 and 3 months after intervention were higher than those of the control group at the same time,and the differences were statistically significant(P<0.05).Conclusion For patients with chronic obstructive pulmonary disease,the establishment of community prevention and control integrated management system can delay the progress of the disease,improve the quality of life,and improve the negative mood,which has high clinical value.