摘要
目的研究家庭肺康复对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期GOLD 3级患者的运动功能、肺功能、生活质量、急性加重次数和再住院时间的影响。方法选取因COPD急性加重(AECOPD)住院的GOLD 3级患者74例,按随机单双数法分为两组,每组各37例。对照组采用常规治疗干预及健康教育;康复组在对照组基础上,于病情平稳后立即实施肺康复干预。随访12个月,观察两组不同随访阶段干预前后的6 min步行试验(six minutes walk test,6MWT)、肺功能、圣乔治呼吸问卷(St.George's Respiratory Questionnaire,SGRQ)评分和再住院时间等变化,并分析比较两组的疗效差异。结果干预1个月后,康复组的疗效不明显。干预6个月后,康复组干预前后6MWT步行距离比较有改善(P<0.05),而对于肺功能而言,仅康复组第1秒用力呼气容积(FEV1)占预计值百分比(FEV1%pred)较干预前改善(P<0.05)。康复组SGRQ症状分、活动分、影响分和总分也均有下降(P<0.05)。干预12个月后,康复组不仅干预前后6MWT步行距离有明显改善(P<0.05),而且FEV1、FEV1%pred比较也均有所增加(P<0.05),用力肺活量(FVC)、FEV1/FVC有轻微的变化(P>0.05),SGRQ评分均明显降低(P<0.01),而对照组均差异无统计学意义(P>0.05)。康复组干预后急性加重次数、住院次数明显减少,且住院次数明显少于对照组(P<0.01),再住院时间明显延长(P<0.05)。结论家庭肺康复不仅可以一定程度上改善COPD患者的呼吸道症状、运动耐力和生活质量,明显延长其再住院时间,降低急性加重发作和住院次数,同时还可减缓肺功能下降速度,甚至有所提高,并且干预时间越长疗效越好。
Objective To evaluate the effect of family pulmonary rehabilitation on motor function,lung function,quality of life,times of acute exacerbation and length of rehospitalization of COPD stable patients with Grade 3 of GOLD.Methods A total of 74 COPD patients with Grade 3 were selected and randomly divided into two groups(n=37).The control group was treated with routine treatment(health education),while the rehabilitation group was treated with pulmo-nary rehabilitation intervention immediately after the condition stabilized.The patients were followed up for 12 months.The changes of 6-minute walk test(6MWT),lung function,SGRQ score and rehospitalization time of the two groups were observed before and after the intervention.Results After one month intervention,the effect of rehabilitation group was not obvious.After 6 months of intervention,the walking distance of 6MWT was significantly improved in rehabilitation group(P<0.05),while FEV1%pred was significantly improved in rehabilitation group(P<0.05).The SGRQ symptom score,activity score,influence score and total score of the two groups also decreased(P<0.05).After 12 months inter-vention,the walking distance of 6MWT in rehabilitation group was significantly improved(P<0.05),FEV1 and FEV1%pred were also significantly increased(P<0.05),FEV1/FVC and FVC were slightly changed(P>0.05),and SGRQ scores were significantly decreased(P<0.01).There was no significant difference in the control group(P>0.05).The times of acute exacerbation and hospitalization in the rehabilitation group before and after intervention were significantly re-duced;the times of hospitalization in the rehabilitation group were significantly less than those in the control group(P<0.01);and the rehospitalization time was significantly longer(P<0.05).Conclusion Family pulmonary rehabilitation can not only improve the respiratory symptoms,exercise endurance and quality of life of COPD patients,significantly pro-long the rehospitalization time,reduce the number of acute exacerbations and hospitalization,but also slow down the de-cline of lung function,and even improve,and the longer the intervention time.
作者
曾小艺
黄倩
马葳
杨添文
李丽
李梅华
ZENG Xiao-yi;HUANG Qian;MA Wei;YANG Tian-wen;LI Li;LI Mei-hua(Department of Respiratory and Critical Care Medicine,Ganmei Hospital affiliated to Kunming Medical University,Kunming 650011,China)
出处
《广东医学》
CAS
2022年第5期534-539,共6页
Guangdong Medical Journal
基金
中国宋庆龄基金会项目(2018MZFC-030)。
关键词
家庭肺康复
慢性阻塞性肺疾病
肺功能
再住院时间
family pulmonary rehabilitation
chronic obstructive pulmonary disease
lung function
rehospitaliza-tion time
作者简介
通信作者:李梅华,主任医师,E-mail:limeihuakm2009@163.com。
