COPD患者随访依从性及其相关因素研究

发布时间：2018-07-04 11:51

本文选题：肺疾病 + 慢性阻塞性　；参考：《中国全科医学》2014年26期

【摘要】：目的分析COPD患者的随访依从性,探讨随访依从性的相关影响因素。方法收录2008年12月—2012年10月就诊于承德医学院附属医院呼吸科的456例COPD患者,对吸烟患者实施医生"劝导戒烟干预";所有患者在进行常规治疗的同时每隔3个月对其进行随访,为期1年。记录COPD患者纳入时和随访满1年时1年内急性加重次数和呼吸困难评分;计算患者随访依从率。结果随访时间满1年时,总体随访依从率为83.3%(380/456)。男性COPD患者随访依从率高于女性(P0.05);不同文化程度、不同肺功能分级COPD患者随访依从率比较,差异有统计学意义(P0.05);吸烟COPD患者随访依从率高于非吸烟患者,差异有统计学意义(P0.05)。失访的76例COPD患者中,因近期自我感觉良好或经济原因拒绝复查28例(36.8%),因家远不能按时随访15例(19.8%),因更换电话号码、错号、公用电话或拒接电话等联系不上14例(18.4%),死于肺部疾病13例(17.1%),死于其他疾病4例(5.3%),随访期间因卧床不能配合肺功能检查2例(2.6%)。随访依从性差组170例(37.3%),依从性好组286例(62.7%)。依从性好组和依从性差组1年内急性加重次数、呼吸困难评分在纳入时和随访满1年时比较,差异均有统计学意义(P0.05)。依从性好组随访1年时1年内急性加重次数、呼吸困难评分均低于依从性差组(P0.05);依从性好组1年内急性加重变化量、呼吸困难评分变化量均低于依从性差组(P0.05)。结论性别、文化程度及疾病严重程度对COPD患者随访依从性均有影响,且随访依从性差异可影响患者的疾病急性加重频率和临床症状,为今后研究提供了参考依据。
[Abstract]:Objective to analyze the follow-up compliance of COPD patients and explore the related factors of follow-up compliance. Methods from December 2008 to October 2012, 456 patients with COPD were admitted to Department of Respiratory, Chengde Medical College. All patients were followed up every 3 months for one year. The acute exacerbation times and dyspnea scores of COPD patients were recorded at the time of admission and 1 year after follow-up, and the compliance rate of the patients was calculated. Results at the end of one year, the overall compliance rate was 83.3% (380 / 456). The follow-up compliance rate of male COPD patients was higher than that of women (P0.05); the follow-up compliance rate of COPD patients with different education levels and different lung function grades was significantly different (P0.05); the follow-up compliance rate of smoking COPD patients was higher than that of non-smoking patients (P0.05). Among the 76 patients with COPD, 28 patients (36.8%) refused to recheck because of recent self-feeling or economic reasons, 15 patients (19.8%) were not able to follow up on time, and the phone number was changed and wrong number was changed. 14 cases (18.4%) could not be contacted by public telephone or refused telephone, 13 cases (17.1%) died of pulmonary diseases, 4 cases (5.3%) died of other diseases, 2 cases (2.6%) were unable to cooperate with lung function examination due to bed-rest during follow-up. There were 170 cases (37.3%) in poor compliance group and 286 cases (62.7%) in good compliance group. The acute exacerbation times and dyspnea scores in compliance group and poor compliance group in one year were significantly different (P0.05). In the compliance group, the acute exacerbation times in one year were lower than those in the poor compliance group (P0.05), and the changes in acute exacerbation and dyspnea scores in the compliance good group were lower than those in the poor compliance group (P0.05). Conclusion Sex, education level and severity of the disease have influence on the follow-up compliance of COPD patients, and the difference of follow-up compliance can affect the acute exacerbation frequency and clinical symptoms of COPD patients, which provides a reference for future research.
【作者单位】：承德医学院附属医院呼吸科;北京大学人民医院呼吸科;
【基金】：中华医学会临床医学慢性呼吸道疾病科研专项资金(07010260034)
【分类号】：R563.9

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