COPD管理云平台的构建及临床应用

doi:10.3877/cma.j.issn.1674-6902.2023.04.006

目的

构建慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)远程智能管理微信小程序云平台，实现对COPD稳定期患者日常规范化管理。

方法

构建基于微信小程序的远程智能管理云平台；选择2020年12月至2022年12月我院收治的COPD患者106例，将云平台管理53例为观察组，常规管理53例为对照组。对比两组1年内治疗依从性、肺功能变化、症状评分、急性加重次数、住院次数、住院费用和住院天数差异，评估平台应用效能。

结果

成功构建COPD远程智能管理微信小程序；观察组较对照组规范用药比例(64.2% vs. 43.4%)高、急性加重次数[(1.04±0.83)次vs.(1.51±0.89)次]少、住院次数[(0.66±0.71)次vs.(1.13±0.86)次]少、住院费用[(0.41±0.41)万元vs.(0.63±0.40)万元]和住院天数[(4.92±4.96)d vs.(7.40±4.95)d]少(P<0.05)。两组肺功能、症状评分无显著差异(P>0.05)。

结论

构建COPD远程智能管理云平台，提高COPD稳定期患者远程自我管理效能，提升生活质量，是"互联网+慢病管理"创新医疗服务模式的有益探索。

关键词: 肺疾病，慢性阻塞性, 微信小程序, COPD远程智能管理, 治疗依从性

Objective

To build a remote intelligent management WeChat mini program cloud platform for COPD, to achieve standardized daily management of COPD stable phase patients.

Methods

It was built that a remote intelligent management cloud platform based on wechat mini program; It was selected that 106 patients with COPD treated in our hospital from December 2020 to December 2022, 53 cases were treated as observation group by cloud platform management, and 53 cases were treated as control group by routine management. Treatment compliance, pulmonary function changes, symptom scores, acute aggravation times, hospitalization times, hospitalization costs and hospitalization days were compared between the two groups within 1 year to evaluate the application effectiveness of the platform.

Results

The wechat mini program of remote intelligent management of COPD was successfully built; The proportion of standard drug use in observation group was higher than that in control group (64.2% vs. 43.4%), the number of acute exacerbations [(1.04±0.83) vs. (1.51±0.89)] less, the number of hospitalizations [(0.66±0.71) vs. (1.13±0.86)] less, the hospitalization cost [(0.41±0.41) yuan vs. (0.63±0.40) yuan] and the length of hospitalization [(4.92±4.96) d vs. (7.40±4.95)d] less, P<0.05. There were no significant differences in pulmonary function and symptom scores between the two groups (P>0.05).

Conclusion

The construction of a remote intelligent management Cloud platform for COPD is beneficial in improving the remote self-management efficacy of COPD stable phase patients, enhancing their quality of life, and is a beneficial exploration of the innovative medical service model of "Internet + chronic disease management" .

Key words: Chronic obstructive pulmonary disease, WeChat app, Remote intelligent management of COPD, Treatment compliance

表1 两组临床基线资料比较

临床资料	观察组(n＝53)	对照组(n＝53)	t(χ²)	P值
年龄(岁)	69.9±9.2	68.9±7.8	0.625	0.533
性别(男/女)	43/10	38/15	1.309	0.253
BMI	22.4±2.5	21.8±2.0	1.334	0.185
吸烟[n(%)]	12(22.60)	11(20.80)	0.056	0.814
饮酒[n(%)]	13(24.50)	6(11.30)	3.142	0.076
肺源性心病[n(%)]	10(18.90)	14(26.40)	0.862	0.353
糖尿病[n(%)]	13(24.50)	9(17.00)	0.918	0.338
FEV₁%pre	49.9±14.5	50.4±15.7	－0.185	0.853
CAT评分	16.3±3.0	1.60±3.2	0.5	0.618
mMRC评分	1.94±0.53	1.92±0.61	0.169	0.866
家庭氧疗[n(%)]	8(15.10)	12(22.60)	0.986	0.321
用药是否规律[n(%)]	18(34.00)	16(30.20)	0.173	0.677
前一年急性加重次数	2.00±0.96	2.02±0.98	－0.11	0.913
前一年住院次数	1.57±0.97	1.72±0.84	－0.856	－0.394

表1 两组临床基线资料比较

临床资料	观察组(n＝53)	对照组(n＝53)	t(χ²)	P值
年龄(岁)	69.9±9.2	68.9±7.8	0.625	0.533
性别(男/女)	43/10	38/15	1.309	0.253
BMI	22.4±2.5	21.8±2.0	1.334	0.185
吸烟[n(%)]	12(22.60)	11(20.80)	0.056	0.814
饮酒[n(%)]	13(24.50)	6(11.30)	3.142	0.076
肺源性心病[n(%)]	10(18.90)	14(26.40)	0.862	0.353
糖尿病[n(%)]	13(24.50)	9(17.00)	0.918	0.338
FEV₁%pre	49.9±14.5	50.4±15.7	－0.185	0.853
CAT评分	16.3±3.0	1.60±3.2	0.5	0.618
mMRC评分	1.94±0.53	1.92±0.61	0.169	0.866
家庭氧疗[n(%)]	8(15.10)	12(22.60)	0.986	0.321
用药是否规律[n(%)]	18(34.00)	16(30.20)	0.173	0.677
前一年急性加重次数	2.00±0.96	2.02±0.98	－0.11	0.913
前一年住院次数	1.57±0.97	1.72±0.84	－0.856	－0.394

表2 6个月后两组管理效果比较[±s，(%)]

临床资料	观察组(n＝53)	对照组(n＝53)	t(χ²)	P值
FEV₁%pre	56.16±13.05	53.43±13.06	1.075	0.285
CAT评分	13.57±2.19	13.75±2.64	－0.401	0.689
mMRC评分	1.72±0.53	1.83±0.67	－0.961	0.339
家庭氧疗[n(%)]	11(20.80)	13(24.50)	0.215	0.643
用药是否规律[n(%)]	34(64.20)	23(43.40)	4.592	0.032
前一年急性加重次	1.04±0.83	1.51±0.89	－2.819	0.006
前一年住院次数	0.66±0.71	1.13±0.86	－3.096	0.003
住院费用	0.41±0.41	0.63±0.40	－2.762	0.007
住院天数	4.92±4.96	7.40±4.95	－2.57	0.012

表2 6个月后两组管理效果比较[±s，(%)]

临床资料	观察组(n＝53)	对照组(n＝53)	t(χ²)	P值
FEV₁%pre	56.16±13.05	53.43±13.06	1.075	0.285
CAT评分	13.57±2.19	13.75±2.64	－0.401	0.689
mMRC评分	1.72±0.53	1.83±0.67	－0.961	0.339
家庭氧疗[n(%)]	11(20.80)	13(24.50)	0.215	0.643
用药是否规律[n(%)]	34(64.20)	23(43.40)	4.592	0.032
前一年急性加重次	1.04±0.83	1.51±0.89	－2.819	0.006
前一年住院次数	0.66±0.71	1.13±0.86	－3.096	0.003
住院费用	0.41±0.41	0.63±0.40	－2.762	0.007
住院天数	4.92±4.96	7.40±4.95	－2.57	0.012

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Construction and clinical application of chronic obstructive pulmonary disease management cloud platform

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Construction and clinical application of chronic obstructive pulmonary disease management cloud platform