医院-社区-家庭联动模式在COPD无创通气规范治疗中的应用研究

Study on Application of Hospital-Community-Family Model in Non-Invasive Ventilation Therapy for COPD

目的 "医院-社区-家庭"联动模式在慢性阻塞性肺疾病(Chronic obstructive pulmonary-disease,COPD)无创通气规范治疗中的应用研究。方法选取2017年2月至2018年1月在我院住院治疗的COPD患者119例,随机分为对照组(60例)和实验组(59例)。实验组实行出院宣教后,采用"医院-社区-家庭"联动模式规范化管理COPD无创通气治疗,对照组实行出院宣教后,常规电话随访,内容包括用药、家用无创通气使用情况。干预1个月、3个月后分别对两组患者的无创通气依从性及患者生活质量进行再次评估。结果干预前患者使用无创通气依从性较低,干预后无创通气依从性明显提高(p<0.05);干预1个月、3个月后,实验组AQ20评分明显低于对照组,差异有统计学意义(p<0.05),干预前后实验组AQ20评分明显好于对照组,差异有统计学意义(p<0.01)。结论 "医院-社区-家庭"联动模式提供系统化、规范化的无创通气治疗,将护理从医院延续到社区和家庭,使患者得到持续的治疗和护理指导,有效提高治疗效果,充分发挥了综合性医院的资源优势。

Objective To study the application of hospital-community-family linkage model in the standardized non-invasive ventilation for chronic obstructive pulmonary-disease(COPD).Methods A total of 119 patients with COPD who were hospitalized in our hospital from February 2017 to January 2018 were selected and randomly divided into the control group(n=60)and the experimental group(n=59).Hospital-community-family linkage model was adopted in the experimental group to standardize the management of non-invasive ventilation for COPD after the education at discharge.The control group was given education at discharge and routine telephone follow-up on medication and the condition of non-invasive ventilation at home.At one month and 3 months after intervention,the compliance with non-invasive ventilation and quality of life of the patients of two groups were evaluated again.Results The compliance with non-invasive ventilation was relatively low before the intervention and was significantly higher after the intervention(p<0.05).The AQ20 score in the experimental group was significantly lower than that in the control group at one month and 3 months after intervention,and the difference was statistically significant(p<0.05).The AQ20 score before and after intervention in the experimental group was significantly higher than that in the control group,and the difference was statistically significant(p<0.01).Conclusion Hospital-community-family linkage model in the management of non-invasive ventilation provides systematic and standardized non-invasive ventilation therapy,extended the care from the hospital to the community and the family,so that patients receive continuous care and guidance and therapeutic effect gets improved.It gives full play to the resource advantages of comprehensive hospitals.