A Clinical Study On Comprehensive Evaluation And Intervention Affecting The Numbers Of Acute Exacerbation And Pulmonary Function In Elderly Patients With COPD In Stable Period

PurposeThrough comprehensive assessment of nutritional status,ability of daily living,weakness and chest muscles in stable elderly patients with chronic obstructive pulmonary disease,and then giving them corresponding interventions and rehabilitation plans based on the evaluation results,the final goal is to reduce the number of acute exacerbation of these elderly patients with chronic obstructive pulmonary disease and improve their pulmonary function.MethodA total of 100 elderly patients with chronic obstructive pulmonary disease that can be summarized in the COPD management clinic of our hospital are selected,and all patients met the criteria for the diagnosis of stable chronic obstructive pulmonary disease in the 2018 Global Initiative for Chronic Obstructive Lung Disease(GOLD guidelines).The patients were randomly divided into a conventional treatment group and a comprehensive intervention group.The conventional treatment group was given symptomatic treatment(relieving cough,phlegm,spasm and asthma)and health education.In the comprehensive intervention group,based on comprehensive assessment of nutritional status,ability of daily living,frailty and chest muscles,patients were given respiratory training and functional exercise of respiratory muscles,sports exercises,oxygen therapy at home,nutrition support and other relevant interventions in addition to the treatment of the conventional treatment group.Patients were followed up in outpatient clinics at the 4th week,12th week,24th week and 52nd week,combined with telephone follow-up,and we could adjust the corresponding interventions for them according to the follow-up results.Observation indexes:1.The main observation indexes are the numbers of acute exacerbation and the improvement effect of pulmonary function of the two groups of patients after the intervention;2.The secondary observation indexes are the frailty score,chest muscle status and MNA scores,ADL scores and CAT scores of the two groups of patients after the intervention.Result1.The numbers of acute exacerbation during the one-year follow-up of patients in the comprehensive intervention group was significantly lower than that in the conventional treatment group,the difference was statistically significant(P<0.05).2.Compared with the conventional treatment group,FEV1 and FEV1%pred of the comprehensive intervention group increased significantly,the difference was statistically significant(P<0.05).FVC also increased compared with the conventional treatment group,but the difference was not statistically significant(P>0.05).3.The Fired frailty scores of the comprehensive intervention group was lower than that of the conventional treatment group,and the difference in the decrease was statistically significant(P<0.05);the pectoralis major muscle cross-sectional area and density and pectoralis major index of the patients with frailty were all better after treatment,the difference in the increase was statistically significant(P<0.05).The pectoralis major muscle area,density,and index of the patients in the conventional treatment group did not change significantly compared with the previous treatment,and the difference before and after the comparison was not statistically significant(P>0.05).4.The MNA scores and ADL scores of the comprehensive intervention group increased more significantly than the conventional treatment group,and the difference was statistically significant(P<0.05);the CAT scores of the comprehensive intervention group decreased more significantly than the conventional treatment group,and the difference was statisticallysignificant(P<0.05).Conclusion 1.Comprehensive assessment and intervention can reduce the numbers of acute exacerbation and improve the pulmonary function of elderly patients with chronic obstructive pulmonary disease in stable period.2.Comprehensive assessment and intervention can effectively improve the frailty of elderly patients with chronic obstructive pulmonary disease in stable period,and to a certain extent improve the condition of the patient’s chest muscles.3.Comprehensive assessment and intervention can improve the MNA scores and ADL scores of elderly patients with chronic obstructive pulmonary disease,reduce the CAT score of these patients,and ultimately improve the patient’s quality of life.