邹龙华 杨洋 尚龙华

[摘要]目的 探讨自我管理教育对无创通气治疗慢性阻塞性肺疾病（COPD）患者自我管理能力及生活质量的影响。方法 选取2016年3月～2018年1月洪都中医院门诊收治的90例无创通气治疗的COPD稳定期患者作为研究对象，根据随机数字表法分为两组，每组各45例。对照组采用常规护理，观察组在对照组基础上联合自我管理教育，3个月为一个疗程。比较两组干预前后的二氧化碳分压（PaCO2）、生活质量评分（SQLI）情况，比较两组的自我效能评分及自我管理能力评分。结果 干预后观察组的PaCO2低于对照组，差异有统计学意义（P<0.05）；干预后观察组的SQLI评分、自我效能评分及自我管理能力评分均高于对照组（P<0.05）。结论 对于COPD缓解期患者而言应用自我管理教育有着重要意义，值得推广。

[关键词]慢性阻塞性肺疾病；自我管理教育；无创通气治疗；自我管理能力；自我效能；生活质量

[中图分类号] R473.5 [文献标识码] A [文章编号] 1674-4721（2018）11（b）-0121-03

[Abstract] Objective To explore the influence of self-management education on self-management ability， self-efficacy and quality of life of non-invasive ventilation for COPD patients. Methods Ninety patients with noninvasive ventilation during the period of stable COPD treated in outpatient department of Hongdu Traditional Chinese Medical Hospital from March 2016 to January 2018 were selected as the study subjects， and divided into two groups according to the random number table method， with 45 cases in each group. In the control group， patients were treated with routine care， and patients in the observation group were treated with self-management education on basis of the control group. Three months were a course of treatment. The PaCO2 and quality of life scores （SQLI） were compared before and after intervention， and the self-efficacy scores and self-management ability scores of the two groups were compared. Results After the intervention， the PaCO2 in the observation group was lower than that in the control group （P<0.05）. After the intervention， the SQLI score， self-efficacy score and self-management ability score of the observation group were higher than those of the control group （P<0.05）. Conclusion The application of self-management education is important for patients with COPD in remission. It is worth promoting.

[Key words] COPD； Self-management education； Non-invasive ventilation； Self-management ability； Self-efficacy； Quality of life

慢性阻塞性肺疾病（COPD）以持續气流受限为特征，可见咳嗽咳痰、胸闷气喘等表现，一旦发病病情可呈进行性加重趋势[1]。目前认为缓解期是COPD治疗的关键时期，及时规范治疗可减少发作次数[2]。家用无创通气是一种行之有效的治疗手段，但受到医学知识欠缺及目前护理方案过于简单的影响，导致不少患者应用时疗效较有限[3]。传统护理模式注重于患者院内情况，且忽视了患者对家庭医疗器械操作的培训管理。近年来自我管理教育在本病中的应用价值逐渐得到重视，本研究旨在探讨其在无创通气COPD患者中的应用价值，现报道如下。

1资料与方法

1.1一般资料

选取2016年3月～2018年1月洪都中医院门诊收治的90例无创通气治疗的COPD稳定期患者作为研究对象，根据随机数字表法分为两组，每组各45例。……