家院联动管理模式在老年慢性阻塞性肺疾病合并肌少症患者中的应用效果研究  

Application Effect of Home-hospital Linkage Management Mode on Elderly Patients with Chronic Obstructive Pulmonary Disease Complicated with Sarcopenia

作　　者：杨明华[1] 徐维国[1] 郭建英[1] 杨琴[1] 夏丽琼[1] YANG Minghua;XU Weiguo;GUO Jianying;YANG Qin;XIA Liqiong(Department of Respiratory and Critical Care Medicine,Mianyang Central Hospital,Mianyang 621000,China)

机构地区：[1]四川省绵阳市中心医院呼吸与危重症医学科,621000

出　　处：《实用心脑肺血管病杂志》2021年第9期107-111,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：中国宋庆龄基金会呼吸疾病临床研究公益基金慢阻肺临床研究专项项目(18ZD001);绵阳市卫生计生委医学科研课题(201513)。

摘　　要：背景肌少症是慢性阻塞性肺疾病(COPD)的并发症之一,其可加重患者病情。如何有效改善COPD合并肌少症患者的预后已成为当前老年医学面临的巨大挑战,而目前针对COPD合并肌少症患者管理的研究报道较少。目的探讨家院联动管理模式在老年COPD合并肌少症患者中的应用效果,为此类患者的康复管理提供参考。方法选取2017-2019年绵阳市中心医院收治的老年COPD合并肌少症患者97例,根据随机数字表法分为对照组49例和研究组48例。对照组患者按照常规管理模式进行管理,研究组患者按照家院联动管理模式进行管理,干预时间均为1年。比较两组患者干预前后肺功能指标〔第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积占用力肺活量比值(FEV_(1)/FVC)〕、四肢骨骼肌质量指数(ASMI)、慢性阻塞性肺疾病评估测试(CAT)评分、日常生活活动能力(ADL)量表评分及出院后1年COPD急性加重次数、再入院次数。结果干预前两组患者FEV_(1)、FEV_(1)/FVC、ASMI、CAT评分、ADL量表评分比较,差异无统计学意义(P>0.05);干预后研究组患者FEV_(1)、FEV_(1)/FVC、ASMI、ADL量表评分高于对照组,CAT评分低于对照组(P<0.05)。两组患者干预后FEV_(1)、FEV_(1)/FVC、ASMI、ADL量表评分分别高于本组干预前,CAT评分分别低于本组干预前(P<0.05)。研究组患者出院后1年COPD急性加重次数、再入院次数少于对照组(P<0.05)。结论家院联动管理模式有助于改善老年COPD合并肌少症患者肺功能,增加其骨骼肌质量,提高ADL,减少COPD急性加重次数及再入院次数。Background Sarcopenia is one of the complications of chronic obstructive pulmonary disease(COPD),it can aggravate the patients'condition.How to effectively improve the prognosis of COPD patients complicated with sarcopenia has become a great challenge for geriatrics.At present,there are few research reports on the intervention of COPD patients complicated with sarcopenia.Objective To explore the application effect of home-hospital linkage management mode on elderly patients with COPD complicated with sarcopenia,in order to provide reference for rehabilitation management of such patients.Methods A total of 97 cases of elderly patients with COPD complicated with sarcopenia were selected form 2017 to 2019 in Mianyang Central Hospital,and they were divided into the control group(n=49)and the study group(n=48)according to random number table method.Patients in the control group were given general management mode,patients in the study group were given home-hospital linkage management mode,both groups were intervented for 1 year.Pulmonary function indexes[forced expiratory volume in one second(FEV_(1)),ratio of forced expiratory volume in one second to forced vital capacity(FEV_(1)/FVC)],appendicular skeletal muscle mass index(ASMI),COPD Assessment Test(CAT)score,Activities of Daily Living(ADL)Scale score before and after intervention and COPD acute exacerbation time and readmissions time within 1 year after discharge were compared between the two groups.Results There was no statistically significant difference in FEV_(1),FEV_(1)/FVC,ASMI and scores of CAT,ADL Scale between the two groups before intervention(P>0.05);after intervention,FEV_(1),FEV_(1)/FVC,ASMI,ADL Scale score in the study group were higher than those in the control group,CAT score was lower than that in the control group(P<0.05).After intervention,FEV_(1),FEV_(1)/FVC,ASMI,ADL Scale score in the two groups were higher than those before intervention,CAT score was lower than that before intervention,respectively(P<0.05).COPD acute exacerbation time and read

关 键 词：慢性阻塞性肺疾病 肌少症 家院联动 老年人 

分 类 号：R563.9[医药卫生—呼吸系统]