慢性阻塞性肺疾病稳定期患者的健康管理
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重庆市卫生计生委医学科研面上项目(20142019)


Health management of patients with chronic obstructive pulmonary disease in stable phase
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    摘要:

    目的探讨健康管理对慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)稳定期患者所产生的影响。方法选取收治的COPD稳定期患者80例,随机分为观察组和对照组各40例。观察组接受1年规范的健康管理;对照组不接受健康管理,患者仍按自己平时的生活习惯及方式生活,根据病情自行决定其就诊时机及用药。1年后观察两组患者吸烟率、肺功能指标、血气分析指标及生活质量情况(CAT评分)的变化,并观察1年内两组患者因病情急性加重而就诊的情况。结果观察组健康管理1年,吸烟率由57.50%降至17.50%,肺功能指标1秒钟用力呼气容积(FEV1)及1秒肿用力呼气容积/用力肺活量(FEV1/FVC)及血气分析指标PaO2及PCO2均有明显改善,CAT评分由(29.75±4.24)降至(26.13±4.42),生活质量提高,其差异均具有统计学意义(P均<0.0001);而对照组管理前后吸烟率由57.50%降至55.00%,差异无统计学意义(P=0.317),肺功能及血气分析指标进一步恶化,CAT评分由(29.73±3.49)升高至(30.63±3.31),生活质量降低,其差异均具有统计学意义(P均<0.0001);1年内观察组因急性加重而就诊的患者为11人次,就诊率为27.5%;而对照组为23人次,就诊率为57.5%,其差异具有统计学意义(P<0.05)。结论对COPD稳定期患者进行规范的健康管理可有效降低患者吸烟率,改善其肺功能及机体供氧,减少反复急性加重,延缓病情发展,提高其生活质量,具有较大的健康效益、经济效益及社会效益,应高度重视COPD稳定期患者的健康管理,并将其大力推广及普及。

    Abstract:

    Objective To investigate the effect of health management on patients with chronic obstructive pulmonary disease(COPD)in stable phase.Methods 80 patients with COPD in our hospital were randomly divided into observation group and control group(n=40).The observation group received one year’s health management interventions,while the control group did not receive.They still maintained the original way of life.The change of smoking rates,pulmonary function index,blood gas analysis index and the quality of life(CAT score)of the two groups were observed after one year,and the situation of visiting Doctors of patients with acute exacerbation of the two groups were observed during one year period.Results In the observation group,the smoking rates decreased from 57.50%to 17.50%,the index of pulmonary function and blood gas analysis were significantly improved,the CAT score decreased from 29.75±4.24to26.13±4.42,and the quality of life improved,which all had a statistically significant differences(P<0.0001).In the control group,the smoking rates just decreased from 57.50%to 55%,which didn’t prove a statistical significance(P=0.317),the pulmonary function and the blood gas analysis further deteriorated,the quality of life further decreased,and the CAT score increased from 29.73±3.49 to 30.63±3.31,which all had a statistically significant differences(P<0.0001).During one year period,there were 11 patients with acute exacerbation in the observation group,and 23patientsin the control group.Hospitalizing rate was 27.5percent in the observation group,and 57.5percent in the control group.There were statistically significant differences between the control group and the observation group(P<0.05).Conclusion Standardized health management on patients with COPD in stable phase can effectively reduce smoking rates,improve the pulmonary function and body oxygen supply,reduce acute exacerbation repeatedly,delay the progression of disease,improve the quality of life of patients.It has great health benefits,economic benefits and social benefits,so that we should attach great importance to the health management interventions for the patients with COPD in stable phase,and promote and popularize it vigorously

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  • 在线发布日期: 2016-12-02
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