【摘要】 目的研究综合干预策略对老年稳定期慢性阻塞性肺疾病(COPD)患者肺功能及生活状态的影响。方法选择2018年12月至2019年12月在本院就诊的120例老年稳定期COPD患者,根据患者干预意愿分成对照组和观察组,每组各60例。对照组予以止咳化痰、解痉平喘等对症治疗,观察组在对症治疗基础之上予以综合干预策略。分别在干预后第1、3、6个月随访,观察2组患者营养状况(MNA)、日常生活能力(ADL)、衰弱状况(MFS)及肺功能的改变。结果观察组患者干预前和干预后1、3、6个月的MNA评分分别为(20.48±0.83)、(21.81±1.28)、(23.39±1.03)、(24.32±0.91)分,干预后6个月与干预前比较差异具有统计学意义(P<0.05),且观察组患者干预后MNA评分均较对照组明显升高(P<0.05)。观察组患者干预前和干预后1、3、6个月的ADL评分分别为(68.50±5.77)、(73.20±5.60)、(85.00±7.07)、(89.58±6.20)分,干预后6个月与干预前比较差异具有统计学意义(P<0.05),且观察组患者干预后ADL评分均较对照组明显升高(P<0.05)。观察组患者干预前和干预后1、3、6个月的MFS评分分别为(38.67±7.97)、(32.75±0.96)、(26.33±8.78)、(18.17±9.61)分,干预后6个月与干预前比较差异具有统计学意义(P<0.05),且观察组患者干预后MFS评分均较对照组明显下降(P<0.05)。干预后2组患者FVC值均有轻微升高,但2组相比差异无统计学意义(P>0.05),观察组患者FEV1由干预前(2.46±0.45)L改善为干预后(2.84±0.26)L,FEV1%由干预前(57.68±12.73)%改善为干预后(77.05±5.92)%,差异具有统计学意义(P均<0.05)。结论综合干预可显著改善老年稳定期COPD患者肺功能水平、日常生活能力、衰弱及营养状况,从而改善患者的生活状态。更多还原

【Abstract】 Objective To study the effect of comprehensive intervention strategies on pulmonary function and life status of elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods A total of 120 elderly patients with stable COPD who were treated at our hospital from December2018 to December 2019 were divided into either an observation group or a control group according to the patients’ willingness, with 60 cases in each group. Patients in both groups were given basic treatments such as relieving cough, phlegm, tracheal spasm, and asthma, and patients in the observation group were additionally given comprehensive intervention strategies. The patients were followed at 1, 3, and 6 months after intervention to observe the changes in nutritional status, the ability of daily life, the weakness status, and the pulmonary function. Results The MNA scores of patients in the observation group at 1, 3, and 6 months after intervention were 21.81±1.28, 23.39±1.03, and 24.32±0.91, respectively, which were significantly higher than that before intervention(20.48±0.83)(P<0.05) and those in the control group after intervention(P<0.05).The ADL scores of patients in the observation group at 1, 3, and 6 months after intervention were73.20±5.60, 85.00±7.07, and 89.58±6.20, respectively, which were significantly higher than that before intervention(68.50±5.77)(P<0.05) and those in the control group after intervention(P<0.05). The MFS scores of patients in the observation group at 1, 3, and 6 months after intervention were 32.75±0.96, 26.33±8.78, and 18.17±9.61, respectively, which were significantly lower than that before intervention(38.67±7.97)(P<0.05) and those in the control group after intervention(P<0.05). After the intervention, the FVC value increased slightly in both groups, and the difference between the two groups was not statistically significant(P>0.05). The FEV1 in the observation group improved from(2.46±0.45) L before intervention to(2.84±0.26) L after management, and FEV1% improved from(57.68±12.73)% before intervention to(77.05±5.92)% after management, the differences were statistically significant(P<0.05). Conclusion Comprehensive intervention strategies can significantly improve the pulmonary function, the ability of daily living, and the frailty and nutritional status of patients with stable COPD, thus improving their life status.更多还原