COPD急性加重期患者出院1个月内非计划性再入院的危险因素调查及护理对策  

Investigation of risk factors for unplanned readmission within 1 month of discharge and nursing countermeasures in patients with acute exacerbation of COPD

作　　者：李素华 杨琼 马东艳 袁紫薇 邵娥芬 邓敏[1] 康云 LI Suhua;YANG Qiong;MA Dongyan;YUAN Ziwei;SHAO Efen;DENG Min;KANG Yun(The First Affi liated Hospital of Kunming Medical University,Kunming 650000,China)

机构地区：[1]昆明医科大学第一附属医院,云南省昆明市650000

出　　处：《护理实践与研究》2024年第5期713-719,共7页Nursing Practice and Research

摘　　要：目的探讨慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者出院1个月内非计划性再入院的危险因素及其护理对策。方法选择医院2020年3月—2022年3月收治的AECOPD患者120例为研究对象,收集患者性别、年龄、吸烟史等一般资料,了解患者基础疾病情况、呼吸困难评分(mMRC)、空腹外周静脉血等实验室指标。以患者出院1个月内非计划性再入院为终点,通过单因素分析、多因素Logistic回归分析筛选1个月内非计划性再入院的影响因素,据此确定护理对策。结果AECOPD患者出院1个月内非计划性再入院23例,单因素分析结果显示,血清C反应蛋白(CRP)、FEF75预计值、FEV1实际值、血清白蛋白(ALB)、气流受限严重程度(GOLD)分级、中性粒细胞与淋巴细胞比(NLR)、呼吸困难评分(mMRC)、血小板与淋巴细胞比(PLR)水平、二氧化碳分压(PaCO_(2))、肺康复锻炼依从性是AECOPD患者出院1个月内非计划性再入院的影响因素(P<0.05)。多因素Logistic回归分析结果显示,FEF75预计值、CRP、ALB、NLR、FEV1实际值和肺康复锻炼依从性是AECOPD患者出院1个月内非计划性再入院的影响因素(P<0.05)。结论针对CRP、PLR、FEF75水平升高和ALB水平、FEV1实际值下降,肺康复锻炼依从性差的AECOPD患者,医院应采取针对性防控措施,提高护理服务质量,减少AECOPD患者非计划性再入院率。Objective To explore the risk factors of unplanned readmission and the nursing countermeasures in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)within 1 month of discharge.Methods 120 cases of AECOPD patients admitted to the hospital from March 2020 to March 2022 were selected as the study subjects,the general data such as gender,age and smoking history were collected,and laboratory indexes such as patients'underlying diseases,modifi ed Medical Research Council(mMRC),and fasting peripheral venous blood were learned.Taking unplanned readmission within 1 month of patients'discharge as the endpoint,the infl uencing factors of unplanned readmission within 1 month were screened by univariate analysis and multifactorial Logistic regression analysis,according to which the nursing countermeasures were determined.Results There were 23 cases of unplanned readmission within 1 month of discharge in AECOPD patients,and the results of univariate analysis showed that serum C-reactive protein(CRP),FEF75 predicted value,FEV1 actual value,serum albumin(ALB),grading of severity of airfl ow limitation(GOLD),neutrophil-to-lymphocyte ratio(NLR),modifi ed Medical Research Council(mMRC),platelet-to lymphocyte ratio(PLR)level,partial pressure of carbon dioxide(PaCO_(2)),and adherence to pulmonary rehabilitation exercises were the infl uencing factors for unplanned readmission within 1 month of discharge in AECOPD patients(P<0.05).The results of multifactorial logistic regression analysis showed that FEF75 predicted value,CRP,ALB,NLR,actual value of FEV1,and adherence to pulmonary rehabilitation exercise were the infl uencing factors for unplanned readmission within 1 month of discharge in patients with AECOPD(P<0.05).Conclusion For AECOPD patients with elevated levels of CRP,PLR,and FEF75 and decreasing levels of ALB and actual values of FEV1,and poor adherence to pulmonary rehabilitation exercises,hospitals should take targeted preventive and control measures,improve the quality of nursing services,and

关 键 词：慢性阻塞性肺疾病 再入院率 影响因素 呼吸困难 肺康复 

分 类 号：R473.56[医药卫生—护理学]