医院-社区-家庭远程肺康复管理在慢性阻塞性肺疾病患者中的效果评价

doi:10.3761/j.issn.0254-1769.2025.20.002

摘要/Abstract

摘要：

目的探讨医院-社区-家庭远程肺康复管理在慢性阻塞性肺疾病（简称慢阻肺）患者中的应用效果，以期为临床护理实践提供参考。方法采用便利抽样法，选取2023年10月—2024年3月在南京市某三级甲等医院呼吸与危重症医学科住院的86例慢阻肺患者为研究对象，将其随机分为试验组与对照组（每组各43例）。试验组接受医院-社区-家庭远程肺康复管理，对照组接受常规家庭肺康复管理，干预时长为3个月。干预后，比较两组的肺康复训练依从性、运动耐力、呼吸困难程度、生活质量、肺功能差异。结果试验组和对照组各纳入42例和40例。干预后，试验组肺康复训练依从性、运动耐力、呼吸困难程度、生活质量均优于对照组，差异有统计学意义（P<0.05），但两组肺功能比较，差异无统计学意义（P>0.05）。结论医院-社区-家庭远程肺康复管理可提高慢阻肺患者的肺康复训练依从性、运动耐力，减轻呼吸困难症状，改善其生活质量。

关键词: 肺疾病，慢性阻塞性, 远程医疗, 肺康复, 依从性, 护理

Abstract:

Objective To explore the application effect of hospital-community-home remote pulmonary rehabilitation management in patients with chronic obstructive pulmonary disease（COPD） and to provide references for clinical nursing practice. Methods The convenience sampling method was adopted to select patients from October 2023 to March 2024. Totally 86 COPD patients admitted to the respiratory department of a tertiary hospital in Nanjing were randomly divided into an experimental group（n=43） and a control group（n=43）. The experimental group received the hospital-community-family triadic closed-loop remote pulmonary rehabilitation care，while the control group received only conventional home-based pulmonary rehabilitation care，and the duration of intervention is 3 months. The differences in adherence to pulmonary rehabilitation training，exercise endurance，degree of dyspnea，quality of life，and lung function were compared between the 2 groups after intervention. Results The experimental group and control group each included 42 cases and 40 cases finally. After intervention，the experimental group showed better outcomes than the control group in adherence to pulmonary rehabilitation training，exercise endurance，degree of dyspnea，quality of life with statistically significant differences（P<0.05）. There were no statistically significant differences between the 2 groups in lung function（P>0.05）. Conclusion The hospital-community-family remote pulmonary re-habilitation management can improve COPD patients’ adherence to pulmonary rehabilitation training，exercise endurance，reduce patient’s dyspnea symptoms and improve quality of life.

Key words: Pulmonary Disease，Chronic Obstructive, Telemedicine, Pulmonary Rehabilitation, Adherence, Nursing Care

张义静, 赵雨婷, 蔡雪, 孙丽. 医院-社区-家庭远程肺康复管理在慢性阻塞性肺疾病患者中的效果评价[J]. 中华护理杂志, 2025, 60(20): 2444-2450.

ZHANG Yijing, ZHAO Yuting, CAI Xue, SUN Li. Application of hospital-community-home remote pulmonary rehabilitation management in patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Nursing, 2025, 60(20): 2444-2450.

图/表 6

表1 慢阻肺患者医院-社区-家庭远程肺康复管理方案

Table 1 Hospital-community-home remote pulmonary rehabilitation management program for patients with COPD

表2 两组一般资料的比较[例（百分比，%）]

Table 2 Comparison of general data between the 2 groups[case（percentage，%）]

表3 干预后两组肺康复训练依从性的比较[例（百分比，%）]

Table 3 Comparison of exercise compliance of pulmonary rehabilitation between the 2 groups [case（percentage，%）]

表4 干预前后两组运动耐力的比较（m，$\bar{x} \pm s$）

Table 4 Comparison of exercise tolerance between the 2 groups（m，$\bar{x} \pm s$）

表5 干预前后两组呼吸困难程度、生活质量的比较[分，M（P25，P75）]

Table 5 Comparison of dyspnea and quality of life between the 2 groups [score，M（P25，P75）]

表6 干预前后两组肺功能的比较（%，$\bar{x} \pm s$）

Table 6 Comparison of lung function between the 2 groups（%，$\bar{x} \pm s$）

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