摘要
目的观察患者需求计划(SNAP)护理干预联合肺康复在慢性阻塞性肺疾病急性加重期(AECOPD)患者中的临床应用效果及安全性。方法选取上海市浦东新区公利医院于2019年9月—2020年1月收治入院的AECOPD患者150例。按照随机数字表法,将患者分为SNAP护理组与对照组各75例。两组患者均给予常规药物治疗、肺康复评估及常规护理,SNAP护理组在此基础上进行为期12周的SNAP护理干预,均随访至52周。测定患者入院、52周时肺功能[第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积占预计值的百分比(FEV_(1)%预计值)]、6 min步行试验距离(6MWTD)、心肺运动功能[峰值运动下的摄氧量(peak VO_(2))、峰值运动下的心率(peak HR)及运动中最低氧饱和度(L-SPO_(2))];随访期间观察患者的急性加重频率、肺康复治疗参与率,并记录患者住院期间出现的不良反应。结果第52周,SNAP护理组的6MWTD、peak VO_(2)、L-SPO_(2)、Peak HR均较治疗前改善,且SNAP护理组的6MWTD、peak VO_(2)、L-SPO_(2)、Peak HR均高于对照组(P均<0.05)。第8、12、24、52周,SNAP护理组的肺康复治疗参与率高于对照组(P均<0.01)。随访52周期间,SNAP护理组中共有19例次发生急性加重,均为轻度发作;对照组中共有40例次发生急性加重且均为中度以上加重;两组急性加重例次比较差异有统计学意义(χ^(2)=12.321,P<0.01)。随访期间两组均未出现不良反应。第12、24、52周,SNAP护理组的SNAP评分均高于对照组(P均<0.01)。结论SNAP护理联合肺康复治疗可在AECOPD患者中安全实施,并可改善AECOPD患者的心肺运动功能,减少急性加重频率;SNAP护理模式可提高AECOPD患者肺康复治疗的参与率及患者的SNAP评分。
Objective To observe the clinical efficacy and safety of the support needs approach for patients(SNAP)nursing model combined with pulmonary rehabilitation in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 150 AECOPD inpatients in Shanghai Pudong New Area Gongli Hospital from September 2019 to January 2020 were recruited.The patients were divided into SNAP group and the control group accord⁃ing to the random umber method,75 cases each.Both groups were given routine drugs,pulmonary rehabilitation evalua⁃tion and nursing treatment.The SNAP group was given SNAP nursing projects continued for 12 weeks.All patients were followed up to 52 weeks.The lung function[forced expiratory volume in one second(FEV_(1)),forced expiratory volume in one second as a percentage of predicted value(FEV_(1)%pre)],6-minute walk distance test(6MWTD),cardiopulmonary exercise test[peak oxygen consumption(peak VO_(2)),peak heart rate(peak HR)and lowest oxygen saturation(L-SPO_(2))]were measured at admission and 52 weeks.During the follow-up period,the frequency of acute exacerbation,the participa⁃tion rate of pulmonary rehabilitation were observed,and adverse reactions occurred were recorded.Results After 52 weeks,the SNAP group showed significant improvement in 6MWTD,peak VO_(2),L-SPO_(2),and Peak HR compared to base⁃line(all P<0.05).Additionally,the SNAP group exhibited statistically significant improvements in 6MWTD,peak VO_(2),L-SPO_(2),and Peak HR compared to the control group(all P<0.05).During the follow-up at the 8th,12th,24th,and 52nd weeks,the participation rate in pulmonary rehabilitation of the SNAP group was higher than that of the control group(all P<0.01).Throughout the 52-week follow-up,there were 19 occurrences of mild exacerbation in the SNAP group,while the control group experienced 40 occurrences of moderate or more severe exacerbation.The difference between the two groups was statistically significant(χ^(2)=12.321,P<0.01).No adverse reactions were observed in
作者
张美兰
刘盼盼
王月娥
陈思佳
赵蕾
ZHANG Meilan;LIU Panpan;WANG Yue'e;CHEN Sijia;ZHAO Lei(Department of Respiratory and Critical Care,Shanghai Pudong New Area Gongli Hospital,Shanghai 200135,China)
出处
《老年医学研究》
2024年第1期47-51,共5页
Geriatrics Research
基金
上海市浦东新区卫生健康委员会卫生科技项目(PW2020A-19,诱导痰尿酸预估COPD急性发作风险及其作用机制研究)
上海市卫生健康委员会面上项目(202040191,高强度间歇训练改善COPD患者运动能力和机体炎症作用的研究)
上海市浦东新区公利医院青年基金项目(2020YQNJJ-13,患者需求计划基于互联网在COPD患者肺运动康复中的应用研究)。
关键词
慢性阻塞性肺疾病
慢性阻塞性肺疾病急性加重期
肺康复
SNAP护理计划
chronic obstructive pulmonary disease
acute exacerbation of chronic obstructive pulmonary disease
pulmonary rehabilitation
SNAP nursing model
