基于A-DROP评分的干预模式对老年社区获得性肺炎患者的康复效果影响

Effect of Intervention Mode Based on A-DROP Score on Rehabilitation of Elderly Patients with Community-acquired Pneumonia

目的 探讨基于A-DROP评分的干预模式对老年社区获得性肺炎(CAP)患者的康复效果。方法 选取2022年2月—2023年2月老年CAP 102例,根据干预模式的不同均分为研究组和对照组。患者全部接受基本治疗和优质护理干预,研究组选择A-DROP评分干预治疗,对照组选择CURB-65评分干预治疗。比较2组病死率、入住重症监护病房(ICU)时间、总住院时间及医疗费用,2组咳嗽消失时间、体温恢复正常时间、肺部啰音消失时间,干预前后肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC]和生活质量。结果 研究组病死率低于对照组,入住ICU时间、总住院时间短于对照组,医疗费用少于对照组(P<0.05,P<0.01)。研究组咳嗽消失时间、体温恢复正常时间、肺部啰音消失时间均短于对照组(P<0.05)。研究组干预后FEV1、FVC、FEV1/FVC高于对照组(P<0.05,P<0.01)。干预后2组SF-36简明健康状况量表各项评分均升高,且研究组高于对照组(P<0.05)。结论 A-DROP评分作为CURB-65评分的改良版,更适合识别高危老年CAP住院患者及评估病情严重程度和死亡风险。

Objective To investigate the rehabilitation effect of intervention mode based on A-DROP score in elderly patients with community-acquired pneumonia(CAP).Methods In total,102 elderly patients with CAP from February 2022 to February 2023 were selected and divided into research group and control group according to different intervention modes.All patients received basic treatment and high-quality nursing intervention,the research group was given A-DROP score-based intervention treatment,the control group was given CURB-65 score-based intervention treatment.The mortality rate,length of stay in intensive care unit(ICU),total length of stay and medical expenses,cough disappearance time,time of temperature return to normal,disappearance time of lung rales,pulmonary function indexes forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC and quality of life before and after intervention were compared between the two groups.Results The mortality rate of the research group was lower than that of the control group,the duration of ICU stay and total length of hospital stay were shorter than that of the control group,and the medical expenses were lower than that of the control group(P<0.05,P<0.01).The disappearance time of cough,time of body temperature return to normal and disappearance time of lung rales in the research group were shorter than those in the control group(P<0.05).After intervention,FEV1,FVC and FEV1/FVC in the research group were higher than those in the control group(P<0.05,P<0.01).After intervention,the scores of the MOS item short from health survey(SF-36)of the two groups were increased,which were higher in the research group than in the control group(P<0.05).Conclusion A-DROP score,as a modified version of CURB-65 score,is more appropriate for identifying high-risk elderly inpatients with CAP and assessing the severity of the disease and the risk of death.