郑杉 赵斐 汪小梅 金华良

[摘要] 目的 研究思維导图引导的康复护理对成人支气管哮喘合并抑郁患者心理状况、肺功能、气道炎症及预后的影响，为临床护理成人支气管哮喘合并抑郁患者提供指导。 方法 选取2016年2月～2019年7月96例在我院诊治的支气管哮喘合并抑郁的成年患者，依据单纯随机抽样的方法分为干预组（n=48）和常规组（n=48），对所选支气管哮喘合并抑郁患者均实施常规护理，干预组患者的常规护理需运用思维导图来引导。通过观察比较两组患者护理前后的抑郁状态、肺功能改善情况、气道炎症水平和生活质量相关指标水平来评价思维导图引导康复护理对成人支气管哮喘合并抑郁患者的影响。 结果 护理后干预组患者的HRSD、SDS评分明显低于常规组，差异有统计学意义（P<0.05）;干预组患者的FEV1%、PEF%明显高于常规组，差异有统计学意义（P<0.05）;干预组患者测定的FeNO水平明显低于常规组，差异有统计学意义（P<0.05）;干预组患者ACT、GQOLI-74评分明显高于常规组，差异有统计学意义（P<0.05）。 结论 运用思维导图引导康复护理，可有效减轻支气管哮喘合并抑郁患者的抑郁情绪，改善患者肺功能情况，控制气道炎症进展，从而能够防止哮喘发作，提高患者的生活质量，改善预后，护理效果显著，可在临床上广泛应用。

[关键词] 思维导图;康复护理;支气管哮喘;肺功能;气道炎症;抑郁

[中图分类号] R562.2          [文献标识码] B          [文章编号] 1673-9701（2020）17-0169-05

Effects of mind map-guided rehabilitation nursing on psychological status， pulmonary function， airway inflammation and prognosis of adult patients with bronchial asthma complicated with depression

ZHENG Shan   ZHAO Fei   WANG Xiaomei   JIN Hualiang

Department of Respiratory Medicine， Hangzhou First People's Hospital， Hangzhou   310000， China

[Abstract] Objective To study the effects of mind map-guided rehabilitation nursing on the psychological status， pulmonary function， airway inflammation and prognosis of adult patients with bronchial asthma complicated with depression， so as to provide guidance for clinical nursing of adult patients with bronchial asthma complicated with depression. Methods A total of 96 adult patients with bronchial asthma complicated with depression who were diagnosed and treated in our hospital from February 2016 to July 2019 were selected. According to the simple random sampling method， the patients were divided into intervention group（n=48） and conventional group（n=48）. Conventional care was carried out for all selected patients with bronchial asthma complicated with depression. The conventional care for patients in the intervention group was guided by mind maps. Levels of related indicators before and after nursing care， such as depression status， pulmonary function improvement， airway inflammation level， and quality of life， were compared between the two groups of patients， and the effects of mind map-guided rehabilitation nursing on adult patients with bronchial asthma complicated with depression were evaluated. Results After nursing， the HRSD and SDS scores of patients in the intervention group were significantly lower than those in the conventional group， and the differences were statistically significant（P<0.05）; the FEV1% and PEF% in the intervention group were significantly higher than those in the conventional group， and the differences were statistically significant（P<0.05）; the levels of FeNO measured in patients in the intervention group were significantly lower than those in the conventional group， and the difference was statistically significant（P<0.05）; the ACT and GQOLI-74 scores in the intervention group were significantly higher than those in the conventional group， and the differences were statistically significant（P<0.05）. Conclusion Mind map-guided rehabilitation nursing can effectively reduce the depression of patients with bronchial asthma complicated with depression， improve the pulmonary function of patients， and control the progression of airway inflammation. Therefore， it can prevent asthma attacks， improve the quality of life， and improve prognosis. The method has a significant nursing effect， which can be widely used in clinical practice.

[Key words] Mind map; Rehabilitation nursing; Bronchial asthma; Pulmonary function; Airway inflammation; Depression

支气管哮喘（Bronchial asthma）是临床上以气流受限可逆和气道高敏感性为特点的呼吸系统疾病，是一种由病原菌重复感染引起的慢性非特异性气道炎症反应，其发生发展由多种细胞和细胞因子介导，发病时常出现反复咳嗽、气促、喘息、胸闷等症状，急性发病时会导致症状加重，严重时甚至会导致患者窒息死亡[1-2]。温度骤减、免疫力下降、烟雾粉尘吸入等因素均会引起支气管哮喘发生。同时，支气管哮喘的发生发展与患者心理健康状态关系密切，患者常因为急性起病、病情加重、担心病情发展、害怕死亡而产生抑郁、焦虑等负性情绪，使得心理状态下滑，萎靡不振。……