微信教育管理对尘肺并稳定期肺结核患者治疗依从性和生活质量的影响

摘要

目的 探讨微信教育管理对尘肺并稳定期肺结核患者治疗依从性和生活质量的影响.方法 选取2015年1月—2017年1月哈尔滨医科大学附属第一医院收治的尘肺并稳定期肺结核患者94例,采用随机数字表法分为对照组和观察组,每组47例.两组患者住院期间均给予常规治疗及肺泡灌洗,对照组患者出院时接受常规健康教育、出院后定期电话随访,观察组患者出院时接受常规健康教育、出院后进行微信教育管理.比较两组患者出院后两周治疗依从性评分、动脉血气分析指标、炎性因子、肺功能指标、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、日常生活活动能力量表(ADL)评分、生活质量评估量表评分.结果 观察组患者治疗依从性评分为(94.7±3.1)分,高于对照组的(87.2±2.8)分(P<0.05).观察组患者动脉血氧分压、动脉血氧饱和度、氧合指数高于对照组,降钙素原、C反应蛋白、白介素6、转化生长因子-β、肿瘤坏死因子α水平低于对照组(P<0.05).观察组患者第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、肺活量(VC)、每分钟最大通气量(MVV)大于对照组(P<0.05).观察组患者SAS评分、SDS评分低于对照组,ADL评分、生活质量评估量表评分高于对照组(P<0.05).结论 微信教育管理可有效提高尘肺并稳定期肺结核患者治疗依从性,改善患者动脉血气分析指标、肺功能,减轻患者炎性反应及焦虑、抑郁程度,提高患者生活质量.%Objective To explore the impact of WeChat educational management on treatment compliance and quality of life in pneumoconiosis patients merged with stable pulmonary tuberculosis.Methods A total of 94 pneumoconiosis patients merged with stable pulmonary tuberculosis were selected in the First Affiliated Hospital of Harbin Medical University from January 2015 to January 2017,and they were divided into control group and observation group according to random number table,each of 47 cases. Based on conventional treatment and bronchoalveolar lavage during hospitalization,patients in control group received routine health education at discharge and regular telephone follow-up after discharge,while patients in observation group received routine health education at discharge and WeChat educational management after discharge. Treatmentcompliance score,arterial blood-gas analysis index,inflammatory cytokines,index of pulmonary function,SAS socre,SDS score,ADL score and Quality of Life Assessment Scale(QOFAS)score were compared between the two groups 2 weeks after discharge.Results Treatment compliance score in observation group was(94.7±3.1),which was statistically significantly higher than that in control group of(87.2±2.8)(P<0.05). PaO2,SaO2 and oxygenation index in observation group were statistically significantly higher than those in control group(P<0.05). PCT,CRP,IL-6,TGF-β,TNF-α in observation group were statistically significantly lower than those in control group(P<0.05). FEV1,FVC,VC and MVV in observation group were statistically significantly larger than those in control group(P<0.05). SAS score and SDS score in observation group were statistically significantly lower than those in control group,while ADL score and QOFAS in observation group were statistically significantly higher than those in control group(P<0.05).Conclusion WeChat educational management can effectively improve the treatment compliance,arterial blood-gas analysis index,pulmonary function and quality of life in pneumoconiosis patients merged with stable pulmonary tuberculosis,relieve the inflammatory reaction,anxiety and depression.