以护士为基础的医护一体化有效排痰管理模式在AECOPD的应用研究  

Study on Application of Nurse-based Integrated Medical Care Model of Effective Sputum Drainage Management in AECOPD

作　　者：段红萍[1] 陈丽妍 黄海英 李满连[1] 林敏[1] 梁世珍[1] DUAN Hongping;CHEN Liyan;HUANG Haiying;LI Manlian;LIN min;LIANG Shizhen(Department of Respiratory Medicine,Zhaoqing First People's Hospital,Zhaoqing,Guangdong 526000)

机构地区：[1]肇庆市第一人民医院呼吸内科,广东肇庆526000

出　　处：《智慧健康》2022年第31期213-216,共4页Smart Healthcare

摘　　要：目的探究以护士为基础的医护一体化管理模式在慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)排痰管理中的应用。方法对2019年1~12月本院收治的92例AECOPD患者进行回顾性分析,其中2019年1~6月收治的43例AECOPD患者为对照组,予常规护理干预模式;2019年7~12月收治的49例AECOPD患者为干预组,在对照组基础上实施以护士为基础的医护一体化管理模式进行干预。比较两组患者干预1w后排痰有效率、呼吸困难程度评分[呼吸困难指数(mMRC)],干预前及干预1w后肺功能指标[第1s用力呼气容积(FEV_(1))占用力肺活量(FVC)比值(FEV_(1)/FVC)、FEV_(1)占预计肺活量比值(FEV_(1)/Pre)]水平。结果干预1w后,干预组排痰有效率、FEV_(1)/FVC、FEV_(1)/Pre水平均明显高于对照组(P<0.05);干预组mMRC水平明显低于对照组(P<0.05)。结论对AECOPD患者实施以护士为基础的医护一体化管理模式,可显著提高其排痰效果,改善肺功能,缓解呼吸困难程度,适宜于临床广泛应用。Objective To explore the application of integrated medical care management model based on nurses in the sputum drainage management in acute exacerbation of chronic obstructive pulmonary disease(COPD)(AECOPD).Methods A retrospective analysis was performed on 92 patients with AECOPD admitted to our hospital from January2019 to December 2019.Among them,43 patients with AECOPD admitted from January 2019 to June 2019 were set as control group and were treated with conventional nursing intervention model,and the other 49 patients with AECOPD admitted from July 2019 to December 2019 were selected as intervention group and implement integrated medical care management model intervention based on nurses on the basis of control group.The effective rate of sputum drainage and dyspnea score[Modified Medical Research Council Dyspnea Index(mMRC)]after 1 w of intervention and lung function indexes[ratio of forced expiratory volume in 1st s(FEV_(1))and forced vital capacity(FVC)(FEV_(1)/FVC),ratio of FEV_(1) and predicted vital capacity(FEV_(1)/Pre)]before intervention and after 1 w of intervention were compared between the two groups.Results After 1 w of intervention,the effective rate of sputum drainage,FEV_(1)/FVC and FEV_(1)/Pre in intervention group were significantly higher than those in control group(P<0.05).The mMRC level in intervention group was significantly lower than that in control group(P<0.05).Conclusion The implementation of integrated medical care management model based on nurses for patients with AECOPD can significantly improve the sputum drainage effect,improve lung function and relieve dyspnea.It is suitable for wide clinical application.

关 键 词：医护一体化管理模式 慢性阻塞性肺病 急性加重期 排痰 

分 类 号：R473.5[医药卫生—护理学]