医共体模式下社区肺康复治疗对慢性阻塞性肺疾病的疗效分析

Analysis of the therapeutic effect of pulmonary rehabilitation therapy on chronic obstructive pulmonary disease under county medical community model

目的研究县域医共体模式下社区肺康复治疗对慢性阻塞性肺疾病(COPD)患者症状、运动耐力和心理状况等方面的影响。方法选取COPD患者77例,进行为期6个月的社区肺康复治疗,并在治疗前后进行肺康复评估,包括COPD评估测试(CAT)评分、肺功能、6 min步行距离及焦虑抑郁评分。结果治疗后,所有患者的CAT评分明显低于治疗前,第一秒用力呼气量占预计值百分比(FEV1%)预计值、第一秒用力呼气量占用力肺活量的百分比(FEV1/FVC)均明显高于治疗前,差异均有统计学意义(Z=6.87,t=-4.02,Z=-5.09,P均<0.05),所有患者汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分均较治疗前降低,差异具有统计学意义(Z分别=-7.25、-7.18,P均<0.05),6 min步行距离明显增加,差异有统计学意义(t=-9.84,P<0.05)。结论通过医共体模式下的COPD社区肺康复干预,可以改善患者的呼吸困难症状、肺功能和运动耐力,减轻焦虑抑郁情绪。

Objective To investigate the effects of community-based pulmonary rehabilitation on symptoms,exercise tolerance,and status of psychology in patients with COPD under the county medical consortium model.Methods Seventy-seven patients diagnosed with COPD were selected.The enrolled patients underwent 6 months of community-based pulmonary rehabilitation,which included respiratory muscle training,exercise,health education,and psychological intervention.Pulmonary rehabilitation assessments were conducted before and after the treatment,including CAT score,lung function,6-minute walking distance,and anxiety and depression scores.Results After treatment,the CAT score of all patients was significantly lower than before treatment,with FEV1%predicted value and FEV1/FVC were significantly higher than before treatment,and the differences were statistically significant(Z=6.87,t=-4.02,Z=-5.09,P<0.05).The HAMA and HAMD scores of all patients decreased compared to before treatment,and the differences were statistically significant(Z=-7.25,-7.18,P<0.05).The 6-minute walking distance increased significantly,and the difference was statistically significant(t=-9.84,P<0.05).Conclusion Through community-based pulmonary rehabilitation interventions under the county medical community model for COPD patients,the symptoms of dyspnea,lung function,exercise tolerance,anxiety,and depression can be improved.