COPD稳定期患者多维度健康管理方案的构建及临床应用研究

Construction and clinical application of multi-dimensional health management scheme for patients with COPD in stable period

目的运用Delphi法构建COPD稳定期患者多维度健康管理方案,并探讨其临床应用效果。方法在文献分析和小组讨论的基础上初步制订多维度健康管理方案,采用Delphi法邀请11名专家对指标体系进行两轮专家函询,确定指标的关键内容。将符合标准的190例患者随机分为观察组(95例)和对照组(95例),对照组实施常规护理,观察组在常规护理的基础上实施多维度健康管理方案,比较两组患者肺功能、运动耐力和日常活动疲劳感。结果干预后,两组患者一秒用力呼气量、用力肺活量均高于干预前,且观察组高于对照组(P<0.01)。干预后,两组患者运动耐力的5次坐立试验时间低于干预前、6 min步行试验距离高于干预前(P<0.01),且观察组患者5次坐立试验低于对照组、6 min步行试验高于对照组(P<0.01)。干预后,两组患者日常活动疲劳感评分均高于干预前,且观察组高于对照组(P<0.01)。结论构建的多维度健康管理方案可提高COPD稳定期患者肺功能、运动耐力,改善COPD患者呼吸困难症状,降低日常活动疲劳感,可在临床推广使用。

Objective Delphi method was used to construct a multi-dimensional health management scheme for COPD patients in stable period,and its clinical effect was discussed.Methods On the basis of literature analysis and group discussion,the multi-dimensional health management scheme was initially formulated,and 11 experts were invited to conduct two rounds of expert correspondence consultation on the indicator system by Delphi method,and the key contents of the indicators were determined.A total of 190 patients meeting the criteria were randomly divided into the observation group(95 cases)and the control group(95 cases).The control group was given routine nursing,and the observation group was given multi-dimensional health management program based on routine nursing.The pulmonary function,exercise endurance and daily activity fatigue of patients in the two groups were compared.Results After intervention,forced expiratory volume in first second and forced vital capacity in two groups were higher than before intervention,and the observation group was higher than the control group(P<0.01).After intervention,the exercise endurance of the two groups was lower than before intervention in five repetition sit-to-stand test,and higher than before intervention in 6-minute walk test(P<0.01).Meanwhile,the five repetition sit-to-stand test in the observation group were lower than that in the control group,and the 6-minute walk test was higher than that in the control group(P<0.01).After intervention,the scores of daily activity fatigue in both groups were higher than before,and the observation group was higher than the control group(P<0.01).Conclusion The constructed multi-dimensional health management scheme for COPD patients can improve pulmonary function,exercise endurance,dyspnea symptoms,and reduce daily activity fatigue in stable COPD patients.It can be promoted and used in clinical practice.