中期照护模式对老年慢性阻塞性肺疾病患者生活质量的效果观察  

Effect of intermediate care on quality of life in elderly patients with chronic obstructive pulmonary disease

作　　者：王垚[1] 李理 沙贵明 张云[1] 王媛[1] Wang Yao;Li Li;Sha Guiming;Zhang Yun;WangYuan(Department of Geriatric,Beijing Geriatric Hospital,Beijing 100095,China)

机构地区：[1]北京老年医院老年示范病房,100095

出　　处：《北京医学》2021年第3期238-242,共5页Beijing Medical Journal

基　　金：首都卫生发展科研专项(首发2018-1-2191)。

摘　　要：目的评估中期照护多学科管理模式对老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者生活质量的效果。方法选取2018年6月至2019年5月北京老年医院住院治疗的老年慢性阻塞性肺疾病急性加重(acute exacerbate of chronic obstructive pulmonary disease,AECOPD)患者160例,采用随机数字表法分为观察组和对照组。观察组给予中期照护多学科干预+常规治疗;对照组仅给予常规治疗。在入组时、中期照护8周及随访6个月、12个月时分别对两组进行日常生活能力量表(activity of daily living scale,ADL)、简易精神状况检查表(mini-mental state examination,MMSE)、简版老年抑郁量表(geriatric depression scale-15,GDS-15)、跌倒风险评估工具(fall risk assessment tool,FRA)、微型营养评估(mini nutritional assessment,MNA)等评分;记录自入组起12个月内,两组出院后因AECOPD再出院人次及在此期间的死亡人数。结果最终纳入患者157例,观察组77例,对照组80例。两组同期对比,观察组ADL(8周时除外)、FRA评分低于对照组,观察组MMSE、MNA评分高于对照组,差异有统计学意义(P<0.05)。观察组中期照护8周及随访6个月、12个月的ADL、GDS-15、FRA、MNA评分较基线的改善情况均较对照组明显,差异有统计学意义(P<0.05);观察组中期照护8周MMSE评分较基线改善与对照组比较,差异有统计学意义(P<0.05)。随访期间观察组因AECOPD再住院24人次,低于对照组的51人次,差异有统计学意义(P<0.05);观察组无死亡病例,对照组死亡2例,差异无统计学意义(P>0.05)。结论中期照护采用多学科整合管理模式,能明显提高老年AECOPD患者的日常生活能力、认知功能、营养状况,改善抑郁,降低跌倒风险,减少再住院人次,较传统医疗有明显优势。Objective To evaluate the efficacy of the multidisciplinary team management model of intermediate care on quality of life in the elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 160 elderly patients with COPD in Beijing Geriatric Hospital from June 2018 to May 2019 were divided into two groups using a random number table.The observation group was given intermediate care multidisciplinary intervention and conventional treatment,the control group was given only conventional treatment.The traditional activity of daily living(ADL),mini-mental state examination(MMSE),and geriatric depression scale-15(GDS-15),fall risk assessment(FRA)and mini-nutritional assessmen(MNA)were evaluated in the two groups at the time of admission,eight weeks,six months and 12 months after treatment.Respectively,the number of the patients who were discharged from hospital because of acute exacerbate of chronic obstructive pulmonary disease(AECOPD)and the number of deaths were recorded within 12 months after discharge.The scores of the scale,the number of rehospitalization and deaths between the two groups were statistically analyzed.Results Seventy-seven patients in the observation group and 80 patients in the control group were included.There was no statistical difference between the observation group and the control group in terms of gender,age and comorbid conditions(P>0.05).In the same period between the two groups,the scores of ADL(except at eight weeks)and FRA in the observation group were lower than those in the control group during the follow-up period;while the scores of MMSE and MNA in the observation group were higher than those in the control group(P<0.05).The improvement of ADL,GDS-15,FRA and MNA scores at eight weeks,six months and 12 months after intermediate care in the observation group was significantly higher than that in the control group(P<0.05).And the MMSE score in the observation group was significantly better than that in the control group only at eight weeks(P<0.05).During the fol

关 键 词：中期照护 多学科管理 老年 慢性阻塞性肺疾病 共病 

分 类 号：R473.5[医药卫生—护理学]