慢性阻塞性肺疾病社区干预防治探索  

Exploration of Community Management on Chronic Obstructive Pulmonary Disease

作　　者：李秀兰[1] 刘菊红[1] 

机构地区：[1]北京市西城区德胜社区卫生服务中心大街南社区卫生服务站,100011

出　　处：《中国全科医学》2008年第10期920-922,共3页Chinese General Practice

摘　　要：目的探索慢性阻塞性肺疾病（COPD）在社区干预防治的效果。方法对本社区5个居委会815例COPD患者进行综合干预，重点采用COPD康复教育，减少COPD危险因素及防止急性发作的措施，测定干预前后患者体质指数（BMI）、6min步行距离、血清清蛋白量、总蛋白量、血氧饱和度（SaO2）和第1s用力呼气量（FEV1）。问卷调查咳嗽、咳痰、呼吸困难的程度，年COPD急性发作及住院次数等。结果COPD患者干预前后咳痰量、咳嗽程度、呼吸困难程度间差异均有统计学意义（P〈0．05）。除应用常规祛痰解痉抗感染药物外，COPD患者干预前后戒烟、使用吸入剂、家庭氧疗、注射疫苗、缩唇呼吸、呼吸操健身运动、应用负氧离子发生器的落实率间差异均有统计学意义（P〈0．05）。除肺功能不全Ⅰ度患者年人均急性发作次数干预前后无变化外，不同肺功能患者年人均住院次数和肺功能不全Ⅱ、Ⅳ度患者年人均急性发作次数干预前后差异均有统计学意义（P〈0．05）。肺功能不全Ⅰ～Ⅳ度患者BMI干预前后差异有统计学意义（P〈0．05）。肺功能不全Ⅱ、Ⅳ度的COPD患者干预前后血清总蛋白量间差异均有统计学意义（P〈0．05）。肺功能不全Ⅱ度患者的6min步行距离干预前后差异有统计学意义（P〈0．05）。结论通过社区综合干预可提高COPD患者生活质量，减少年均急性发作及住院次数，改善患者总体状况。Objective To explore the effects of comprehensive management on chronic obstructive pulmonary disease （COPD） in community. Methods Comprehensive managements had been taken for 815 patients with COPD in our community. The managements included health education, the nutritional and rehabilitative instructions, carrying out the measures which could reduce the dangerous factors and prevent the acute episode of COPD. Then test the body mass index （ BMI）, the serum albumin and total protein level, the distance of six - mimute walk （ambulation） （6MWT） and forced expiratory volume in one second ratio （FEV1） and oxygen percent saturation （ SAO2% ） respectively before and after management. We also investigated patients cough, expectoration, dyspnea and hospitalization frequency by questionary. Results After community management, carrying out the measures of reducing dangerous factors and proventing COPD acute episode increased significantly. The hospitalization frequency annually reduced significantly. BMI and the serum total protein level increased significantly （ P 〈 0.05 ）. Conclusion Community managements to COPD patients can reduce the hospitalization frequency and acute episode, Therefore it can improve patients＇ whole body condition and amendment life quanlity.

关 键 词：肺疾病 慢性阻塞性 社区卫生服务 治疗 

分 类 号：R563[医药卫生—呼吸系统]