Application effect of cluster management in peri-discharge period of patients with acute exacerbation of chronic obstructive pulmonary disease

doi:10.11958/20252239

Abstract

Abstract:

Objective To investigate the application effect of cluster management in peri-discharge period of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Using random number table method, 90 patients with AECOPD were divided into the observation group (45 cases) and the control group (45 cases). All patients underwent active treatment after admission. During the peri-discharge period, the control group received routine management, while the observation group received cluster management based on internet chronic obstructive pulmonary disease (COPD) management platform. Both groups received 12 weeks of intervention. Comparisons were made between the two groups in terms of the degree of dyspnea [modified British Medical Research Council dyspnoea scale (mMRC) dyspnoea scale], pulmonary function [forced expiratory volume in the first second as a percentage of predicted value (FEV1%pred)], exercise endurance [6-minute walk test (6MWT)], management effect (frequency of emergency infusion or hospitalization due to moderate to severe acute exacerbation, frequency of multidisciplinary outpatient follow-up, compliance with regular home-based rehabilitation and proportions of smokers before and after intervention), and levels of laboratory indices [hemoglobin (Hb) and albumin (Alb)]. Results After intervention, mMRC score of the observation group decreased and was lower than that of the control group (P<0.05). The observation group showed an increase in FEV1%pred and 6 MWT distance, both of which were superior to those in the control group (P<0.05). The proportion of smokers and number of emergency infusions or hospitalization diagnosis and treatment due to moderate-severe acute exacerbation in the observation group were lower than those in the control group. The proportion of regular home-based rehabilitation and multidisciplinary outpatient follow-up visits were higher/more in the observation group than those in the control group (P<0.05). The levels of Hb and Alb in the observation group increased compared to those before intervention and were higher than those in the control group. Hb level in the control group decreased compared to that before intervention (P<0.05). Conclusion Implementing cluster management during the peri-discharge period of patients with AECOPD can effectively alleviate dyspnea, improve exercise endurance, reduce acute exacerbation risk and promote the development of healthy behaviors.

Key words: pulmonary disease, chronic obstructive, rehabilitation, acute exacerbation, cluster management, pulmonary rehabilitation, peri-discharge period, exercise endurance

CLC Number:

R563.9

Figures/Tables 6

References 18

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组别	男性	年龄/岁	COPD病程/年	吸烟
对照组	38（75.11）	72.36±5.76	10.00（6.00，10.00）	41（91.11）
观察组	40（88.89）	70.13±5.37	10.00（5.00，14.00）	40（88.89）
χ²、t或Z	0.385	1.238	0.713	0.123
组别		BMI/（kg/m²）	文化程度
组别		BMI/（kg/m²）	初中及以下	中专/高中	大专及以上
对照组		25.16±4.46	24（53.33）	13（28.89）	8（17.78）
观察组		24.52±5.15	20（44.44）	17（37.78）	8（17.78）
χ²或t		0.630	0.897

组别	男性	年龄/岁	COPD病程/年	吸烟
对照组	38（75.11）	72.36±5.76	10.00（6.00，10.00）	41（91.11）
观察组	40（88.89）	70.13±5.37	10.00（5.00，14.00）	40（88.89）
χ²、t或Z	0.385	1.238	0.713	0.123
组别		BMI/（kg/m²）	文化程度
组别		BMI/（kg/m²）	初中及以下	中专/高中	大专及以上
对照组		25.16±4.46	24（53.33）	13（28.89）	8（17.78）
观察组		24.52±5.15	20（44.44）	17（37.78）	8（17.78）
χ²或t		0.630	0.897

组别	n	干预前	干预后	Z
对照组	45	2.00（1.00，3.00）	2.00（1.00，3.00）	1.366
观察组	45	2.00（2.00，3.00）	2.00（1.00，2.00）	4.959^＊＊
Z		1.670	2.339^＊

组别	n	干预前	干预后	Z
对照组	45	2.00（1.00，3.00）	2.00（1.00，3.00）	1.366
观察组	45	2.00（2.00，3.00）	2.00（1.00，2.00）	4.959^＊＊
Z		1.670	2.339^＊

组别	n	FEV1%pred/%
组别	n	干预前	干预后	t
对照组	45	53.13±13.24	59.35±15.25	2.652^＊
观察组	45	52.43±20.85	66.44±17.03	4.898^＊＊
t		0.189	2.080^＊
组别	6 MWT/m
组别	干预前		干预后	t
对照组	283.73±142.88		295.51±121.53	1.097
观察组	282.67±142.27		362.78±158.27	11.277^＊＊
t	0.460		2.487^＊