基于多学科的PCMH团队模式在改善慢性阻塞性肺疾病患者症状中的应用研究  

Research on the application of multidisciplinary teams based on PCMH concept in COPD patients

作　　者：赵虹 李亚妹[1] 秦立志[1] 赵洁[3] ZHAO Hong;LI Yashu;QIN Lizhi;ZHAO Jie(Department of Respiratory Medicine,Hebei Chest Hospital,Shijiangzhuang,Hebei 050041,China;Key Laboratory,Hebei Chest Hospital,Shijiangzhuang,Hebei 050041,China;Gongli Hospital of Pudong new area,Shanghai 200135,China)

机构地区：[1]河北省胸科医院呼吸内科,河北石家庄050041 [2]河北省胸科医院河北省肺病重点实验室,河北石家庄050041 [3]上海市浦东新区公利医院,上海200135

出　　处：《临床肺科杂志》2024年第10期1520-1524,1530,共6页Journal of Clinical Pulmonary Medicine

基　　金：河北省医学科学研究课题计划项目(No.20231222)。

摘　　要：目的探讨多学科的PCMH团队模式对慢阻肺患者康复管理的有效性。方法通过回顾性队列研究,选取2022年3月1日-2022年9月30日我院呼吸与危重症医学科就诊的慢阻肺患者,审查指标包括PCMH理念的MDT管理前后第6个月和第12个月的患者住院次数、急诊次数(ED)、急性发作次数,此外还评估了开展PCMH管理对慢阻肺患者的尼古丁依赖性、症状和吸烟行为影响。结果患者开始接受PCMH管理后第6个月的住院次数、急诊次数分别为(0.1±0.2)次和(0.2±0.3)次,显著少于首次就诊前6个月的(0.5±0.3)次住院次数和(0.6±0.4)次急诊次数(P<0.001),管理后第12个月的住院次数、急诊次数分别为(0.3±0.5)次和(0.3±0.4)次,显著少于首次就诊前6个月的(0.7±0.5)次住院次数和(0.8±0.4)次急诊次数(P<0.001),急性发作次数在首次就诊前后6个月和12个月并未出现显著性差异(P=0.070);患者平均每日吸烟数量在实施PCMH管理后从(15.2±10.7)支减小到了(11.3±8.2)支,FTND得分从(4.3±1.8)分减小到了(3.4±2.1)分,CAT得分从(19.1±7.2)分减小到(15.2±6.1)分,均具有统计学差异(P<0.05)。结论基于多学科的PCMH管理方法有助于减轻患者症状、降低吸烟率,明显改善慢阻肺患者健康。Objective To explore the effectiveness of a multidisciplinary PCMH team model in rehabilitation management for patients with chronic obstructive pulmonary disease(COPD).Methods A retrospective cohort study was conducted to select COPD patients who visited the Respiratory and Critical Care Medicine Department of our hospital from March 1,2022 to September 30,2022.The review indicators included the number of hospital admission,emergency department visits(ED),and acute episodes at the 6th and 12th months before and after MDT management under the PCMH concept.In addition,the impact of PCMH management on nicotine dependence,symptoms,and smoking behavior in COPD patients was evaluated.Conclusion The patient’s hospitalization and emergency visits at the 6th month after receiving PCMH management were 0.1±0.2 and 0.2±0.3,respectively,significantly lower than 0.5±0.3 hospitalization and 0.6±0.4 emergency visits at the 6th month before the first visit(P<0.001).The hospitalization and emergency visits at the 12th month after management were 0.3±0.5 and 0.3±0.4,respectively,significantly lower than the 0.7±0.5 hospitalization and 0.8±0.4 emergency visits at the 6th month before the first visit(P<0.001).There was no significant difference in the number of acute attacks between 6 and 12 months before and after the first visit(P=0.070).The average daily smoking volume of patients decreased from 15.2±10.7 to 11.3±8.2 after implementing PCMH management,the FTND score decreased from 4.3±1.8 to 3.4±2.1,and the CAT score decreased from 19.1±7.2 to 15.2±6.1,all of which showed statistical differences(P<0.05).Conclusion A multidisciplinary PCMH management method can help alleviate patient symptoms,reduce smoking rates,and significantly improve the health of COPD patients.

关 键 词：PCMH 多学科团队 慢性阻塞性肺疾病慢阻肺 吸烟 

分 类 号：R563.9[医药卫生—呼吸系统]