卢红梅, 李冉冉, 邬亭亭, 廖蕾. 循证护理模式对慢性阻塞性肺疾病患者治疗效果[J]. 职业卫生与应急救援, 2019, 37(2): 130-134. DOI: 10.16369/j.oher.issn.1007-1326.2019.02.007
引用本文: 卢红梅, 李冉冉, 邬亭亭, 廖蕾. 循证护理模式对慢性阻塞性肺疾病患者治疗效果[J]. 职业卫生与应急救援, 2019, 37(2): 130-134. DOI: 10.16369/j.oher.issn.1007-1326.2019.02.007
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LU Hongmei, LI Ranran, WU Tingting, LIAO Le. Effects of evidence-based nursing for treatment of patients with chronic obstructive pulmonary disease[J]. Occupational Health and Emergency Rescue, 2019, 37(2): 130-134. DOI: 10.16369/j.oher.issn.1007-1326.2019.02.007
Citation: LU Hongmei, LI Ranran, WU Tingting, LIAO Le. Effects of evidence-based nursing for treatment of patients with chronic obstructive pulmonary disease[J]. Occupational Health and Emergency Rescue, 2019, 37(2): 130-134. DOI: 10.16369/j.oher.issn.1007-1326.2019.02.007
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循证护理模式对慢性阻塞性肺疾病患者治疗效果

Effects of evidence-based nursing for treatment of patients with chronic obstructive pulmonary disease

    摘要
  • 摘要:
    目的 探究循证护理模式对慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）患者治疗依从性和肺功能的影响及其对COPD急性加重（acute exacerbation of COPD，AECOPD）的预防价值。
    方法 选择2016年1月至2017年5月收治的COPD患者86例，随机分为循证组和对照组，各43例，在常规治疗的基础上，对照组采用常规护理模式，循证组采用循证护理模式各护理6个月，院外随访12个月。比较两组护理前后各项疗效指标。
    结果 与护理前相比，两组的FEV1%、FEV1/FVC、COPD评估测试（COPD assessment test，CAT）评分和6 min步行试验（6 minute walk test，6 MWT）距离等指标均有改善（P < 0.05）；循证组的FEV1%、FEV1/FVC和6 MWT距离高于对照组，CAT评分低于对照组，差异有统计学意义（P < 0.05）。护理后，两组患者焦虑自评量表（self-rating anxiety scale，SAS）和抑郁自评量表（self-rating depression scale，SDS）评分降低，服药依从性自我效能量表（medication adherence self-efficacy scale，MASES）和生命质量测定量表（EORTC QLQC30）评分升高，差异均有统计学意义（P < 0.05）；循证组SAS和SDS评分低于对照组，MASES和QLQ-C30评分高于对照组，差异有统计学意义（P < 0.05）。对照组和循证组在出院后12个月内的AECOPD发生率分别为67.44%（29/43）和46.51%（20/43），经log-rank检验，循证组发生AECOPD风险的低于对照组（P < 0.05）。对照组和循证组在出院后12个月内分别有2例和1例死亡病例。
    结论 循证护理模式可以有效改善COPD患者的症状和焦虑抑郁状态，提高肺功能和治疗依从性，降低AECOPD发生风险。

     

    Abstract:
    Objective The effect of evidence-based nursing for treatment of patients with chronic obstructive pulmonary disease (COPD) was evaluated with the indicators of patients' compliance, improvement of pulmonary function and prevention of AECOPD(acute exacerbation of COPD).
    Methods During January 2016 to May 2017, 86 hospitalized patients with COPD were divided into two groups(each 43 cases), namely nursing with evidence-based model group and nursing with common model(as reference) group. All patients were followed up for 12 months. The indicators, including pulmonary function, CAT scores, and 6-minute walking tests before and after treatment, as well as the scores of self-rating anxiety and depression scores, treatment compliance, and quality of life were compared between these two groups. The differences of AEECOPD seizures and death risk between the two groups were analyzed.
    Results The FEV1%, FEV1/FVC, 6MWT and the CAT scores of patients in both groups were significantly improved after being treatment(P < 0.05), and the patients in the evidence-based nursing group showed more improvement compared with patients in the reference group (P < 0.05). Similarly, the scores of SAS, SDS, MASES, and QLQ-C30 of all patients were improved after treatment and the patients in the evidence-based nursing group showed more improvement (P < 0.05). It was found that the incidence of acute attacks in the reference group and evidence-based nursing group within 12 months after discharge was 67.44%(29/43)and 46.51%(20/43), respectively. The risk of acute attacks in the evidence-based nursing group was significantly lower than that in the reference group. There were 2 cases of death in the reference group and 1 case of death in the evidence-based nursing group within 12 months after discharge.
    Conclusion The evidence-based nursing model could effectively improve the symptoms, anxiety and depression status of COPD patients, improve lung function and treatment compliance, and significantly reduce the risk of acute exacerbations of COPD.

     

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