综合性肺康复在中、重度COPD患者中的临床应用

伏冉; 王贻; 陶佳丽; 李刚; 万玉峰; 何远强; 徐传芹; 郑玉龙

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伏冉，王贻，陶佳丽，李刚，万玉峰，何远强，徐传芹，郑玉龙.综合性肺康复在中、重度COPD患者中的临床应用[J].中华物理医学与康复杂志,2018,40(5):368-372

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综合性肺康复在中、重度COPD患者中的临床应用

Pulmonary rehabilitation for patients with moderate or severe obstructive pulmonary disease

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中文关键词: 综合性肺康复慢性阻塞性肺疾病 6分钟步行距离生活质量心理状态

英文关键词: Pulmonary rehabilitation Obstructive pulmonary disease Six-minute walking distance Life quality Psychological health

基金项目:淮安市医学科技发展基金(HAS2015011)

作者	单位
伏冉，王贻，陶佳丽，李刚，万玉峰，何远强，徐传芹，郑玉龙	223002 徐州，徐州医科大学附属淮安医院呼吸内科

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中文摘要:

目的观察综合性肺康复对中、重度慢性阻塞性肺疾病（COPD）患者的临床疗效。方法选取符合标准的中、重度COPD患者135例，按随机数字表法将其随机分为康复组75例和对照组60例。分级为B级、C级COPD患者共135名，使用随机数字表法随机分为2组，其中康复组75名，对照组60名。2组患者均给予COPD稳定期的常规治疗，康复组在此基础上给予综合性肺康复治疗（包括健康教育、运动锻炼、呼吸功能锻炼、呼吸肌训练、心理支持及营养干预等），2组均连续干预6个月。2组患者均于干预前和干预6个月后（干预后）采用6 min步行距离（6MWD）、气促指数、慢性阻塞性肺疾病评估测试量表（CAT）、贝克焦虑和抑郁量表、微型营养评价法（MNA）、肺功能和血气指标等评估其运动能力、气促程度、营养状态、肺功能和动脉血氧分压。结果干预后，康复组患者的6 MWD、气促指数、CAT评分、贝克焦虑评分、贝克抑郁评分、FEV1、FVC和PaO2分别为（425.1±81.2）m、（3.15±0.17）级、（10.7±5.9）分、（7.49±5.42）分、（6.88±4.73）分、（2.46±0.45）L、（3.15±0.23）L、（68.8±7.45）mmHg，分别与组内干预前和对照组干预后比较，差异均有统计学意义（P<0.05）。结论综合性肺康复干预可增强中、重度稳定期COPD患者的运动能力、气促程度、肺功能和动脉血氧分压，同时还可其减轻焦虑和抑郁症状。

英文摘要:

Objective To observe any curative effect of applying comprehensive pulmonary rehabilitation in moderate and severe cases of chronic obstructive pulmonary disease (COPD). Methods A total of 135 persons hospitalized with moderate or severe COPD were randomly divided into a rehabilitation group of 75 and a control group of 60. Both groups were given routine treatment, while the rehabilitation group was additionally provided with a comprehensive pulmonary rehabilitation regimen, including health education, exercise training, respiratory function training, respiratory muscle training, psychological support and nutritional intervention for six months. Before and after the treatment, both groups were evaluated using their walking distance within 6 minutes (6MWD), an anhelation index, a COPD assessment test (CAT), the Beck anxiety and depression scale, a nutritional assessment and indexes of pulmonary function and blood gases. Results After the intervention the average 6 MWD, anhelation index, CAT score, Beck anxiety and depression scores, forced expiratory volume, forced vital capacity and PaO2 of the rehabilitation group were all significantly better than before the treatment and better than those of the control group. Conclusion For moderate and severe COPD patients, comprehensive pulmonary rehabilitation effectively strengthens their moving ability, pulmonary function and arterial partial pressure of oxygen, while relieving anhelation, anxiety and depression.

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