“五段式”培训方法在家庭无创通气治疗稳定期COPD患者中的应用  

Application of five-segemental care model for chronic obstructive pulmonary disease patients with non-invasive mechanical ventilation

作　　者：席芳[1] 李亚军[1] 叶松岩[2] 

机构地区：[1]郑州大学人民医院(河南省人民医院)呼吸与危重症学科,450003 [2]郑州大学人民医院(河南省人民医院)神经内科,450003

出　　处：《中华现代护理杂志》2015年第17期1999-2002,共4页Chinese Journal of Modern Nursing

摘　　要：目的：探讨“五段式”培训方法在家庭无创通气治疗稳定期 COPD 患者中的应用。方法2011年8月—2013年2月将70例行家庭无创通气的COPD稳定期患者,随机分为干预组和对照组,各35例,干预组实施“五段式”无创通气培训指导,对照组实施常规的无创通气治疗及健康指导,比较两组出院时及出院后6个月的肺功能、血气分析、急性加重次数。结果出院6个月后,干预组二氧化碳分压（PaCO2）、氧分压（PaO2）、FEV1/FVC值分别为（61.3±5.2）mmHg,（58.4±4.7）mmHg,（66.8±16.3）%,与对照组比较差异无统计学意义（t值分别为-0.159,0.477,0.968；P〉0.05）。干预组出院6个月内急性加重次数为（2.5±1.1）次,对照组为（3.4±2.1）次,两组比较差异有统计学意义（t =-3.696,P〈0.01）。结论应用“五段式”无创通气培训方法能够提高COPD稳定期患者家庭无创通气的应用水平,改善生活质量,降低急性加重次数,有效延缓COPD的病情发展。Objective To evaluate the effect of five-segemental care model for chronic obstructive pulmonary disease patients with non-invasive mechanical ventilation. Methods A total of 70 community-dwelling COPD patients with non-invasive mechanical ventilation were randomly divided into two groups, with 35 cases in each group. The patients in the control group received routine discharge guidance and follow-up education, while the patients and their family members in the experimental group participated in five-segemental care model within two months after discharge. The frequency of acute exacerbations, lung function and blood gas parameters, as well as the quality of life when discharge and at 6 months after discharge were compared between two groups. Results After 6 month of discharge, the PaCO2 , PaO2 and FEV1/FVC of the experimental group were （61. 3 ± 5. 2）mmHg, （58. 4 ± 4. 7） mmHg, and （66. 8 ± 16. 3）%, which had no significant differences compared with the control groups （t= -0. 159,0. 477, 0. 968;P〉0. 05）. After 6 month of discharge, the times of acute exacerbation were （2. 5 ± 1. 1） of the experimental group and （3. 4 ± 2. 1） of the control group. There was significant difference between two groups （t= -3. 696,P〈0. 01）. Conclusions The application of five-segemental care model can improve COPD patients′ self-care knowledge and skills, promote patients′compliance on the application of non-invasive mechanical ventilation, reduce the frequency of acute exacerbations and improve the patients′quality of life.

关 键 词：肺疾病 慢性阻塞性 肺功能 生活质量 五段式培训 无创通气 

分 类 号：R473.5[医药卫生—护理学]