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有创家庭机械通气:生活条件及与健康相关的生活质量

Invasive home mechanical ventilation: living conditions and health-related quality of life.

作者信息

Huttmann Sophie Emilia, Windisch Wolfram, Storre Jan Hendrik

机构信息

Department of Pneumology, Cologne-Merheim Hospital, Kliniken der Stadt Köln, Witten-Herdecke University Hospital, Cologne, Germany.

出版信息

Respiration. 2015;89(4):312-21. doi: 10.1159/000375169. Epub 2015 Mar 19.

Abstract

BACKGROUND

The number of patients with invasive home mechanical ventilation (HMV) following unsuccessful weaning is steadily increasing, but little is known about the living conditions and health-related quality of life (HRQL) in these patients.

OBJECTIVES

To establish detailed information on living conditions and HRQL in patients with invasive HMV.

METHODS

The Severe Respiratory Insufficiency Questionnaire (SRI) was used to measure specific HRQL aspects in addition to patient interviews on individual living conditions during home visits.

RESULTS

Thirty-two patients with lung disease, most prominently COPD (n = 18), and neuromuscular disorders (n = 14) were included. The overall mean SRI summary scale score (range 0-100) was 53 ± 16, with a broad range amongst individuals (23-86). Neuromuscular patients were younger than those with lung diseases (49 ± 18 vs. 67 ± 11 years; p < 0.005), and although they had a higher nursing dependency and fewer comorbidities, they tended to have higher (better) SRI summary scale scores (58 ± 16 vs. 48 ± 15; p = 0.092). Living in a private home compared to living in nursing facilities did not influence the SRI scores.

CONCLUSIONS

Patients undergoing invasive HMV primarily following unsuccessful weaning reported an individual HRQL which, when taken together, was highly heterogeneous and ranged from very good to extremely bad. Older patients with COPD and more comorbidities are likely to have a worse HRQL than neuromuscular patients, while the living situation does not influence the HRQL.

摘要

背景

撤机失败后接受有创家庭机械通气(HMV)的患者数量正在稳步增加,但对于这些患者的生活状况和健康相关生活质量(HRQL)知之甚少。

目的

获取接受有创HMV患者生活状况和HRQL的详细信息。

方法

除了在家庭访视期间就个体生活状况对患者进行访谈外,还使用严重呼吸功能不全问卷(SRI)来测量特定的HRQL方面。

结果

纳入了32例患有肺部疾病的患者,其中最常见的是慢性阻塞性肺疾病(COPD,n = 18)和神经肌肉疾病(n = 14)。SRI总评分量表的总体平均得分(范围0 - 100)为53±16,个体得分范围较广(23 - 86)。神经肌肉疾病患者比肺部疾病患者年轻(49±18岁对67±11岁;p < 0.005),尽管他们的护理依赖程度更高且合并症较少,但他们的SRI总评分量表得分往往更高(更好)(58±16对48±15;p = 0.092)。与住在护理机构相比,住在私人住宅对SRI评分没有影响。

结论

主要在撤机失败后接受有创HMV的患者报告的个体HRQL总体差异很大,范围从非常好到极其差。患有COPD且合并症较多的老年患者的HRQL可能比神经肌肉疾病患者更差,而生活状况不会影响HRQL。

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