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目的 探讨干预管理对慢性阻塞性肺疾病(COPD)患者生存质量的影响.方法 门诊或病房收治的COPD患者90例,按照就诊顺序随机分为管理组和对照组,对照组给予常规治疗,管理组在常规治疗的基础上纳入管理,为每位患者建立个人健康档案,进行COPD防治知识讲座、戒烟宣传教育、呼吸功能锻炼、用药指导、心理疏导,时间为6个月,测定2组患者入选前后吸炯率、6分钟步行距离(6MWD/m)、圣乔治呼吸问题调查问卷(SGRQ)评分变化.结果 6个月后管理组吸烟率较对照组下降(x2=4.464,P＜0.05),管理组戒烟率较对照组增高(x2=9.119,P＜0.05).随访6个月后对照组6MWD/m为(318.7±70.6)m,与入选时相比差异无统计学意义(t=4.84,P=0.024);管理组6 MWD/m为(372.0±76.3)m,较健康教育管理前增加(t=-7.14,P=0.00).管理组6个月后呼吸症状、活动受限、疾病影响及SGRQ总评分(45.3±18.1)、(36.8±23.1)、(34.5±21.4)、(40.5±21.3)均较管理前(62.1±21.8)、(53.9±19.7)、(48.6±20.3)、(53.7±18.6)下降(t=6.15、5.18、4.70、5.07,均P＜0.05);对照组6个月后呼吸症状、活动受限、疾病影响及SGRQ总评分与入选时比较,差异无统计学意义(t=-2.03、-1.24、-4.17、-2.95,均P＞0.05).结论 对COPD患者干预管理可以降低患者吸烟率、增强患者运动耐力,提高患者生存质量.

Objective To evaluate the impacts of health management on quality of life of patients with chronic obstructive pulmonary disease (COPD).Methods Ninety COPD in-or out-patients were assigned to two groups according to visit date.The control group was treated with conventional therapy,and the observation group obtained conventional therapy + standard health management for 6 months.Cigarette smoking,6 MWT/m and The St George's Respiratory Questionnaire (SGRQ) were evaluated before and after the intervention.Results At 6 months,the ratio of current cigarette smoking of the observation group was much lower than that at baseline (x2=4.464,P＜0.05),6 MWD/m was significantly increased (337.2±82.6 vs 372.0±76.3,t=-7.14,P=0.00),and the scores of respiratory symptoms,limitation of motion and influence of disease and total score of SGRQ were significantly reduced (t values were 6.15,5.18,4.70 and 5.07,respectively; all P＜0.05).Conclusion Standard health management could decrease the rate of current cigarette smoking and improve exercise tolerance and the quality of life of COPD patients.