慢性阻塞性肺疾病筛查及个案管理.docVIP

慢性阻塞性肺疾病筛查及个案管理 　　摘要：目的 探讨慢性阻塞性肺疾病（COPD）筛查及个案管理。方法 采用配对随机、前瞻性的研究方法，通过肺功能检查筛选COPD患者，配对随机分成干预组和对照组，干预组进行4站式规范管理，分别为全科医师或社区护士进行健康宣教；全科医师给予临床指导；康复医师提供康复评估和训练；营养指导师提供营养评估和指导。每季度进行一次，每站每次均15 min。对照组仅接受门诊随访。通过对干预组与对照组及干预组前后肺功能、生命质量评分及年急性加重次数数据进行统计分析。结果 干预后两组COPD患者肺功能及生命质量均有提高，年急性发作次数降低，但干预组患者肺功能、生命质量及年急性发作次数优于对照组，差异具有统计学意义（P0.05）。结论 4站式个案管理能够提高慢性阻塞性肺疾病患者的肺功能及生命质量，降低年急性发作次数，适合在社区中推广。 　　关键词：慢性阻塞性肺疾病；个案管理；肺功能；生命质量 　　Abstract：Objective To investigate the screening and case management of chronic obstructive pulmonary disease（COPD）.Methods The study of the random and prospective study of the paired，COPD patients were screened by pulmonary function test，The matched pairs were randomly divided into the intervention group and the control group.The intervention group was conducted in 4 stations，Include：Health education for general practitioners or community nurses；Clinical guidance for general practitioners；Rehabilitation physicians provide rehabilitation assessment and training；Nutritional assessment and guidance to provide nutrition to the instructor.Once a quarter，15 minutes per station.Control group only received outpatient follow-up.Statistical analysis of the data of lung function，life quality score and the number of acute exacerbation in the intervention group and the control group and the intervention group.Results The pulmonary function and life quality of the two groups of patients with COPD were improved，and the number of acute exacerbation was decreased，but the pulmonary function，life quality and the number of acute attack in the intervention group were better than those in the control group.The difference was statistically significant（P0.05）.Conclusion Four case management can improve the lung function and life quality of patients with chronic obstructive pulmonary disease，and reduce the number of acute attacks，which is suitable for the promotion in the community. 　　Key words：Chronic obstructive pulmonary disease；Case management；Pulmonary function；Quality of lif