Health Effect of Forest Bathing Trip on Elderly Patients with Chronic Obstructive Pulmonary Disease

Forest bathing trip is a short, leisurely visit to forest. In this study we determined the health effects of forest bathing trip on elderly patients with chronic obstructive pulmonary disease （COPD）. The patients were randomly divided into two groups. One group was sent to forest, and the other was sent to an urban area as control. Flow cytometry, ELISA, and profile of mood states （POMS） evaluation were performed. In the forest group,

Protective effect of sevoflurane on lung function of elderly chronic obstructive pulmonary disease patients undergoing total hip arthroplasty

BACKGROUND Chronic obstructive pulmonary disease(COPD)is a common respiratory disorder that affects the elderly population and increases the risk of postoperative pulmonary complications(PPCs)after major surgeries.Sevoflurane is a volatile anesthetic that has been shown to have anti-inflammatory and antioxidant properties and attenuate lung injury in animal models.AIM To evaluate the protective effect of sevoflurane on the lung function of elderly COPD patients undergoing total hip arthroplasty(THA).METHODS In this randomized controlled trial,we randomly assigned 120 elderly patients with COPD,who were scheduled for THA,to receive either sevoflurane(sevoflurane group)or propofol(propofol group)as the maintenance anesthetic.The primary outcome was the incidence of PPCs within seven days after surgery.The secondary outcomes were changes in the lung function parameters,inflammatory markers,oxidative stress markers,and postoperative pain scores.RESULTS The results showed that the incidence of PPCs was significantly lower in the sevoflurane group than in the propofol group(10%vs 25%,P=0.02).Furthermore,the decline in the forced expiratory volume in 1 s,forced vital capacity,and peak expiratory flow was significantly lesser in the sevoflurane group than in the propofol group at 24 h and 48 h after surgery(P<0.05).The interleukin-6,tumor necrosis factor-alpha,malondialdehyde,and 8-hydroxy-2α-deoxyguanosine levels were significantly lower in the sevoflurane group than in the propofol group at 24 h after surgery(P<0.05).The sevoflurane group showed significantly lower postoperative pain scores than the propofol group at 6 h,12 h,and 24 h after surgery(P<0.05).CONCLUSION Sevoflurane protects the lung function of elderly COPD patients undergoing THA under general anesthesia by reducing the incidence of PPCs,attenuating inflammatory and oxidative stress responses,and alleviating postoperative pain.

Effect of Family Nutrition Therapy on Elderly Patients with Chronic Obstructive Pulmonary Disease

Objective:The aim of the study was to explore the influence of family enteral nutrition support on nutritional status,lung function,activity tolerance and quality of life in elderly patients with chronic obstructive pulmonary disease(COPD)in stable stage and malnutrition.Methods:A prospective observational study of COPD and malnutrition in the geriatric department of our hospital,control group(n=82)and intervention group n=82).The control group was treated with conventional diet,and the intervention group was treated with conventional diet and enteral nutrition suspension.One month later,observe the nutrition indicators,lung function,exercise tolerance and quality of life.Results:(1)BMI and ALB were higher than control group(t=10.465,6.189,P<0.05),TP and Hb had no change,(t=1.310,1.302,P>0.05).(2)FVC,FEV1,FEV1/FVC,FEV1%were higher than control group(t=11.999,19.654,13.418,16.924,P<0.05).(3)the quality of life symptom score,activity score,influence score and total score were lower than control group(t=15.303,6.773,23.600,14.766,P<0.05),and 6MWT were higher than control group(t=111.962,P<0.05).Conclusion:Oral enteral nutritioncan improve the nutritional status,lung function,activity tolerance and quality of life of elderly patients with COPD in stable stage and malnutrition.It can be a early,safe and effective nutritional support strategy for COPD patients with malnutrition。

Update on the use of portable monitoring system for the diagnosis of sleep apnea in specific population

The prevalence and severity of obstructive sleep apnea(OSA) is higher in specific population: children, elderly,obese and patients with pulmonary and cardiovascular diseases, compared to the general population. OSA is associated with greater morbidity and mortality in these patients. Although full-night polysomnography is still the gold standard diagnostic sleep study for OSA, it is a time consuming, expensive and technically demanding exam. Over the last few years, there is growing evidence on the use of portable monitors(PM) as an alternative for the diagnosis of OSA. These devices were developed specially for sleep evaluation at home, at a familiar environment, with easy selfapplication of monitoring, unattended. The use of PM is stablished for populations with high pre-test probability of OSA. However, there is a lack of studies on the use of PM in age extremes and patients with comorbidities. The purpose of this review is to present the studies that evaluated the use of PM in specific population, as well as to describe the advantages, limitations and applications of these devices in this particular group of patients. Although the total loss rate of recordings is variable in different studies, the agreement with fullnight polysomnography justifies the use of PM in this population.

The relationship between the expression of transient receptor potential vanilloid 1 and the airway remodeling in elderly patients with chronic obstructive pulmonary disease

Objective To investigate the relationship between the expression of trannsient receptor potential vanilloid(TRPV1)and the severity of airway remodeling in elderly patients with chronic obstructive pulmonary disease(COPD).Methods According to airflow obstruction severity,totally 100 cases of elderly patients with

Effect of warming needle moxibustion on pulmonary function of elderly patients with stable chronic obstructive pulmonary disease

Objective To observe the therapeutic effects of warming needle moxibustion on pulmonary function of elderly patients with stable chronic obstructive pulmonary disease. Method Eighty elderly patients with stable chronic obstructive pulmonary disease were divided randomly into an acupuncture group and a drug group, with forty cases in each group. The patients in the acupuncture group were treated with warming needle moxibustion on specific acupoints. Main acupoints include Zusanli （足三里 ST 36）, Feishu （肺俞 BL 13） and Dingchuan （定喘 EX-B 1）. Matching acupoints include Gaohuang （膏肓 BL 43）, Xinshu （心俞 BL 15）, Dazhui （大椎 GV 14） and Fangmen （风门 BE 12）. The acupoints were punctured with even reinforcing and reducing method. Meanwhile, two moxa stick of warming needle moxibustion were applied separately at the acupoints at back and ST 36. The needles were retained for approximately 0.5 h each time. The treatment was given every other day, 3 times a week and the course of treatment was 8 weeks. Patients in the drug group were treated by seretide inhalation （50 μg salmeterol and 250 μg fluticasone propionate）, twice a day for 8 weeks. The improvement in pulmonary function and the symptom of chills and fever were compared between the two groups. Results After treatment, pulmonary function indices [forced expiratory volume in one second （FEV1）, forced expiratory volume in one second to forced vital capacity （FEVl/FVC）, forced expiratory volume in one second to predicted value ratio （FEV1%） and peak expiratory flow （PEF）] of the patients in both groups were improved significantly compared with that before treatment （P〈0.05）. There was no statistically significant difference between the two groups （all P〉0.05）. Improvement in comprehensive scores of the symptom of chill and fever in the acupuncture group was significantly superior to that in the drug group after 4 and 8 weeks of the treatment, respectively （P〈0.05）. Conclusion Warming needle moxibustion was obviously effective on the improvement in pulmonary function of elderly patients with stable chronic obstructive pulmonary disease.

慢性阻塞性肺疾病患者抑郁、焦虑情绪调查

目的:发现慢性阻塞性肺疾病(COPD)病人伴抑郁、焦虑情绪的患病率,并分析其相关的影响因素。方法:对62例COPD患者进行了一般情况及医院焦虑抑郁量表(HospitalAnxietyandDepressionScale,HAD)问卷调查。结果:有抑郁情绪的患者42人(67.7%)。有焦虑情绪的患者的43人(69.3%)。14例III级COPD患者中达到抑郁、焦虑症状肯定存在标准的均有13人,高达92.8%。Logistic多因素回归分析,男性比女性病人更易出现抑郁和焦虑症状(OR值分别为1.05,95%CI1.01￣2.11,1.12,95%CI1.03￣2.23),肺功能差的患者更易出现抑郁和焦虑症状(OR值分别为2.34,95%CI1.98￣3.21,2.53,95%CI2.11￣4.01);对病情越了解的病人更易出现抑郁和焦虑症状(OR值分别为1.22,95%CI0.98￣1.54,1.25,95%CI1.01￣2.31)。结论:COPD患者中存在较高的抑郁及焦虑情绪障碍,肺功能受损程度是其主要影响因素。

高原地区肺心病患者血清碱性成纤维细胞生长因子水平与肺动脉压的关系

目的探讨血清碱性成纤维细胞生长因子（bFGF）在低氧性肺动脉高压发病中的作用。方法采用双抗体夹心酶联免疫吸附法（ELISA）检测高原地区（海拔2260～3300m）38例慢性肺源性心脏病（肺心病）急性加重期患者、30例慢性阻塞性肺疾病（COPD）缓解期患者和30例当地健康人血清bFGF含量，并使用彩色多普勒超声心动仪测定肺动脉血流频谱，计算平均肺动脉压（MPAP），使用血气分析仪测定动脉血氧分压（PaO2）。结果肺心病组血清bFGF（87．54±12．15）ng／L、MPAP（45．86±5．63）mmHg（1mm Hg-0．133 kPa）显著高于COPD组[分别为（55．72±9．08）ng／L和（22．95±2．56）mmHg，P均＜0．01]，COPD组显著高于健康对照组[分别为（49．83±8．78）ng／L和（20．34±2．23）mmHg，P均＜0．05]；肺心病组PaO2[（38．79±4．56）mmHg]显著低于COPD组[（58．22±6．18）mmHg，P＜0．01]，COPD组则显著低于健康对照组[（66．57±5．48）mmHg，P＜0．01]。肺心病组和COPD组血清bFGF水平与MPAP均呈显著正相关（r肺心病=0．788，rCOPD=0．674，P均＜0．01），与PaO2均呈显著负相关（r肺心病=-0．735，rCOPD=-0．587，P均＜0．01）。结论慢性肺心病患者血清bFGF水平明显升高，可能与其慢性低氧性肺动脉高压形成有一定关系。

MMPs系统和细胞因子在慢性阻塞性肺疾病模型大鼠中的作用

目的观察慢性阻塞性肺疾病(COPD)模型大鼠基质金属蛋白酶及炎性细胞因子的变化。方法将30只大鼠随机分为正常组、模型组,每组15只。除正常组外,其余大鼠采用烟熏加脂多糖(LPS)气管滴入方法建立COPD大鼠模型,模型复制成功第28天,采用动物肺功能仪检测大鼠肺功能,酶联免疫吸附法观察大鼠血清白介素(IL)-1β、IL-10、IL-8、TGF-β1,免疫组化观察肺组织MMP-9及TIMP-1变化。结果模型组大鼠肺泡腔及肺间质内大量炎性细胞浸润,肺组织结构破坏。与正常组比较,模型组大鼠肺功能参数FEV0.3、FEV0.3/FVC、PEF值降低,Re升高(P<0.01,P<0.05);模型组大鼠IL-1β、IL-8、MMP-9表达水平较正常组明显升高,IL-10、TGF-β1、TIMP-1表达降低(P<0.05,P<0.01)。相关性分析显示肺功能参数FEV0.3与MMP-9呈负相关,FEV0.3/FVC与血清IL-1β呈负相关,PEF与血清IL-8呈负相关(P<0.05);FEV0.3/FVC、Re与TIMP-1呈正相关(P<0.05);MMP-9与IL-1β、IL-8呈正相关,TIMP-1与TGF-β1呈正相关(P<0.05,P<0.01);MMP-9与TGF-β1呈负相关(P<0.05)。结论 COPD的炎症反应与MMP-9/TIMP-1失衡有关,炎性细胞表达MMP-9占优势,炎症反应明显,最终导致肺功能降低。

综合护理干预对老年慢性阻塞性肺疾病患者治疗依从性的影响

目的探讨综合干预对老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者治疗依从性的影响。方法自制调查问卷对80例COPD患者治疗中存在的问题进行调查,对调查发现的COPD患者存在的认知误区及健康教育的难点采取针对性的综合干预。结果综合干预后COPD患者急性发作次数、感冒次数、生存质量评分均明显下降,差异有统计学意义(P<0.01);吸烟人数、行炊人数明显减少;康复治疗、家庭氧疗、吸入治疗等人数明显增加,差异有统计学意义(P<0.01)。结论 积极综合护理干预可提高COPD患者治疗依从性,改善生存质量,减少复发。

热毒宁对流感病毒感染致AECOPD患者呼吸困难评分及氧化应激的作用

目的:研究热毒宁对慢性阻塞性肺疾病合并流感病毒感染患者呼吸困难评分及氧化应激水平的作用。方法:选取可疑病毒感染的慢性阻塞性肺病(COPD)门诊患者320例,用RT-PCR方法检测病人痰液中流感病毒。共检出流感病毒阳性者42例,随机分为热毒宁组(接受热毒宁治疗)和对照组。比较治疗后,两组患者呼吸困难评分[呼吸困难表(MRC)和基础呼吸困难指数(BDI)]、诱导痰中氧化应激因子丙二醛(MDA)、超氧化物歧化酶(SOD)水平及血浆炎症因子(IL-6、IL-8)水平。结果:治疗后,热毒宁组BDI高于对照组(P<0.05),而两组MRC评分无统计学差异。热毒宁组诱导痰中MDA、SOD及血浆中IL-8的水平与对照组比较差异均有统计学意义(P<0.05)。结论:热毒宁通过调节氧化应激水平,改善流感病毒感染的慢性阻塞性肺疾病的呼吸困难情况。

无创机械通气不同吸气压力对慢性阻塞性肺疾病急性加重期患者腹内压的影响

目的探讨不同吸气压力（IPAP）对慢性阻塞性肺疾病急性加重期（AECOPD）无创正压机械通气患者腹内压（IAP）的影响。方法选取60例AECOPD无创正压机械通气患者，行机械通气前测量患者IAP值，行无创正压机械通气后，按照正压机械通气不同吸气压力将患者随机分为三组：10-14cmH2O（A组），15～19cmH20（B组），20～25cmH2O（C组）；每组各20例患者，分别于调整吸气压力后2h、第1～7天每天同一时间点监测患者IAP。结果与A组、B组比较，C组患者IAP差异有统计学意义（P〈0．05）；A组与B组比较差异无统计学意义（P〉0．05）。同一组不同监测时间点比较，通气后2h及通气后第1天与其他时间点比较差异有统计学意义（P〈0．05）。结论对于AECOPD无创正压机械通气患者，随着吸气压力水平的升高，患者IAP有升高趋势，并且在早期较明显。因此，在无创正压机械通气早期，监测患者IAP可能有益于为患者选择适合的吸气压力支持水平。

三级联合护理干预对农村老年COPD患者在家庭康复中的认知与心理健康研究

目的探讨区县级医院-乡镇卫生院-村卫生服务站的三级联合护理干预模式对农村地区COPD老年患者家庭康复认知与心理健康的影响。方法选取2017年1月至12月某区级医院呼吸内科治疗出院后在农村居住的老年COPD患者120例,干预组和对照组各60例,对照组实施常规随访健康教育,干预组在对照组基础上成立COPD干预小组、建立患者三级联合护理档案、制订个性化家庭康复计划。结果干预后,干预组患者疾病认知、自我护理能力、抑郁、焦虑、肺功能均优于对照组(P<0.01或P<0.05)。结论三级联合护理干预模式利于提高农村地区老年COPD患者家庭康复的认知能力,改善患者负性情绪,提高生存质量。

低磷血症对慢性阻塞性肺疾病急性加重期患者预后的影响

目的探讨低磷血症在慢性阻塞性肺病急性加重期(AECOPD)患者中的发生率及预后的影响。方法选取2012年1月—2016年6月入住重症医学科(ICU)AECOPD患者86例,根据患者血磷检测值分为正常血磷组和低血磷组,比较两组患者Apache Ⅱ评分、肌酐、血钾、血钠、pH、血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、机械通气时间、ICU入住时间、住院时间、6个月再入院率、住院期间病死率和死亡率。结果低磷血症总体发生率为53.49%,低磷血症组患者平均住院日、ICU入住时间、机械通气时间较正常组均显著延长[(16.38±9.26)vs(4.65±2.20);(8.05±6.91)vs(2.78±1.44);P<0.05)],且6个月生存率明显较正常血磷组降低(P<0.05)。结论低磷血症在AECOPD患者的发病率高,机械通气时间及住院时间延长,提示患者预后不良。

胸部CT对COPD合并肺动脉高压分级诊断价值

目的:结合多普勒超声心动图对比分析胸部CT平扫在慢性阻塞性肺病(COPD)合并肺动脉高压(PAH)分级上的诊断价值。方法:回顾性分析100例经多普勒超声心动图检查确诊、分级的COPD合并PAH患者的胸部CT平扫资料,测量CT所示的主肺动脉直径、右肺动脉直径及左肺动脉直径,并与30例未发生PAH的COPD患者的上述胸部CT平扫资料对比,分析它们与PAH分级的关系,并进行统计学分析。结果:100例COPD并PAH患者中,经超声心动图确诊为轻度PAH 57人,中度PAH 27例,重度PAH 16例。上述三组PAH患者CT上所测量的主肺动脉直径,方差分析得出三者间的差别有统计学意义,两两比较发现:轻度组PAH的主肺动脉直径与中度组PAH的主肺动脉直径有统计学差异(P=0.017);轻度组PAH的主肺动脉直径与重度组PAH的主肺动脉直径有统计学差异(P=0.000);中度组PAH的主肺动脉直径与重度组PAH的主肺动脉直径有统计学差异(P=0.031);轻度组PAH的主肺动脉直径<中度组PAH的主肺动脉直径<重度组PAH的主肺动脉直径。轻度PAH的主肺动脉直径约为29.71 mm±3.57 mm,最佳诊断阈值是29.11 mm;中度PAH的主肺动脉直径约为31.77 mm±3.44 mm,最佳诊断阈值是30.53 mm;重度PAH的主肺动脉直径约为34.28 mm±4.14 mm,最佳诊断阈值是32.00 mm。结论:胸部CT平扫通过测量主肺动脉直径对COPD并PAH的分级具有一定的诊断价值。

自身缺氧状态认识的提高对COPD患者吸氧依从性及生活质量的影响

目的探讨自身缺氧状态认识的提高对吸氧依从性及生活质量的影响.方法选择需长期氧疗(LTOT)的COPD患者60例,随机分为对照组和教育组.两组患者在接受教育前平均每天吸氧时间和生活质量的差异均无统计学意义[(4.1±3.6)h/d比(3.8±3.5)h/d,(70.07±11.52)%比(65.15±13.73)%,P>0.05].两组病人均接受常规教育,教育组增加对自身机体缺氧状态认识的教育.比较各组教育前后和两组间吸氧时间和生活质量的差异.结果两组接受教育后吸氧时间提高[(4.1±3.6)h/d比(6.6±3.8)h/d,(3.8±3.5)h/d比(8.7±3.5)h/d,P<0.05]和总体生活质量提高[(70.07±11.52)%比(64.09±10.41)%,(65.15±13.73)%比(58.50±10.46)%,P<0.05].教育组病人的吸氧时间和总体生活质量较对照组改善[(6.6±3.8)h/d比(8.7±3.5)h/d,(64.09±10.41)%比(58.50±10.46)%,P<0.05],但患者心理和社会功能受损程度评分的差异并无统计学差异[(62.62±10.99)%比(57.47±10.52)%,P>0.05].结论对COPD患者LTOT的健康教育内容应包括对自身机体缺氧状态认识的教育,它可以更明显的改善患者的氧疗依从性及生活质量,但不能改善患者心理和社会功能受损程度.

吸入用布地奈德混悬液和吸入用异丙托溴铵溶液雾化吸入治疗慢性阻塞性肺疾病的疗效分析

目的探讨吸入用布地奈德混悬液和吸入用异丙托溴铵溶液雾化吸入治疗慢性阻塞性肺疾病(COPD)的临床疗效。方法选取我院呼吸科2009年1月～2012年1月慢性阻塞性肺疾病患者60例,按照不同给药方法分为对照组和治疗组各30例,两组均给予常规治疗的同时,对照组单独给予吸入用异丙托溴铵溶液雾化吸入治疗,治疗组给予吸入用布地奈德混悬液和吸入用异丙托溴铵溶液雾化吸入治疗。结果治疗7～10d后,治疗组显效率及总有效率(36.7%,93.3%)均显著高于对照组(23.3%,66.7%),P<0.05。治疗后两组PaO2、PaCO2及FEV1均有明显改善,与治疗前比较,有显著性差异(P<0.05)。治疗后两组比较差异有显著性意义(P<0.05),治疗组咳嗽缓解快,气促呼吸困难消失时间、喘憋消失时间、肺部体征消失时间较对照组短,同时也减少了患者住院时间。结论吸入用布地奈德混悬液和吸入用异丙托溴铵溶液雾化吸入治疗慢性阻塞性肺疾病(COPD),能迅速缓解患者病情,改善肺功能,显著缩短患者住院时间,是治疗慢性阻塞性肺疾病(COPD)的有效选择。

高压力家庭无创通气对稳定期慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的疗效研究

目的:研究高压力家庭无创通气对稳定期慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的疗效。方法:选取2013年7月-2016年2月因慢性阻塞性肺急性加重且合并Ⅱ型呼吸衰竭在本科室住院,经治疗后病情平稳仍伴有二氧化碳潴留的患者36例。按照随机数字表法分为试验组和对照组,各18例。两组患者均出院后在家中继续使用无创通气,试验组使用高吸气压力,对照组使用常规吸气压力,比较治疗前与治疗6个月后两组患者的FVC、FEV_1、PaCO_2、PaO_2数值及呼吸困难评分。结果:两组治疗后的PaCO_2、PaO_2与治疗前比较,差异均有统计学意义(P<0.05);且试验组治疗后的PaCO_2、PaO_2与对照组比较,差异均有统计学意义(P<0.05);而试验组治疗后的FVC、FEV_1与治疗前及对照组比较,差异均无统计学意义(P>0.05);两组治疗后呼吸困难评分比较,差异无统计学意义(P>0.05)。结论:高压力家庭无创通气对稳定期慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的患者降低二氧化碳潴留比低压力效果更好,但两者对肺功能和运动耐力改善无差异。

六君子汤对慢性阻塞性肺疾病患者内源性抗炎机制影响

目的:探讨六君子汤治疗慢性阻塞性肺疾病(COPD)患者的临床疗效及对内源性抗炎机制的影响。方法:采用单盲随机的方法,将60例Ⅱ级COPD稳定期患者(中医辨证属脾虚型)分成2组,治疗组30例常规西医治疗联合六君子汤治疗,对照组30例常规西医治疗,疗程均为3个月。疗程结束后进行综合疗效评价及痰液细胞HDACs活性、TNF-α、NF-κB、IL-1β、IL-8等细胞因子的测定,并进行比较。结果 (:1)临床总有效率,治疗组为96.67%,对照组为80%,两组比较,差异有统计学意义(P<0.01);(2)治疗后治疗组痰液HDACs活性、细胞因子(TNF-α、NF-κB、IL-1β、IL-8)水平与对照组比较,差异有统计学意义(P<0.05)。结论:六君子汤治疗COPD(脾虚型)患者具有较好的临床疗效,能够降低COPD患者痰液TNF-α、NF-κB、IL-1β、IL-8水平,提高HDACs活性,恢复HDACs功能,改善糖皮质激素作用的敏感性,从而恢复COPD气道抗炎系统功能。

系统化健康教育对航天科工集团公司职工慢性阻塞性肺疾病患者效果分析

目的 研究系统化健康教育对航天科工集团公司职工慢性阻塞性肺疾病（COPD）患者效果。方法 选取2014年9~11月航天科工集团在航天中心医院治疗的50名COPD患者,根据随机数字表法分为对照组和观察组,两组患者均进行常规治疗,观察组患者在COPD基础治疗措施上进行系统化健康教育。分别在治疗前后对患者动脉血氧分压（PaO_2）、动脉血氧饱和度（SaO_2）、动脉二氧化碳分压（PaCO_2）、氧合指数（OI）等血气指标进行测定;在治疗前后对两组患者的生活质量进行评估;使用肺功能仪评估患者肺功能;记录1年内两组患者急性发作次数、再住院率及死亡例数。结果 治疗后观察组患者第一秒用力呼气量占用力肺活量比重（FEV1/FEV1）预计值,FEV1/FVC和最大通气量（MVV）均显著高于对照组（P〈0.05）。治疗后观察组患者PaO_2、SaO_2以及OI均显著高于对照组（P〈0.05）,PaCO_2显著低于对照组（P〈0.05）。治疗后,观察组患者躯体功能、情绪功能、生活技能评分均较对照组显著偏高,差异有统计学意义（P〈0.05）;观察组患者急性发作率和再住院率均显著低于对照组（P〈0.05）。结论 系统化健康教育管理可有效改善患者肺功能、血气指标,提高患者生活质量,改善COPD患者远期预后。