健康教育及康复锻炼对慢性阻塞性肺疾病稳定期患者心肺功能的影响  

The effects of health education and rehabilitation exercise on the lung function and exercise capacity of patients with stable chronic obstructive pulmonary disease

作　　者：刘秋云[1] 赵静[1] 王苑[1] 崔英[1] 夏婕[1] 李春燕[1] 林英翔[1] 杨汀[1] 王辰[1] 

机构地区：[1]首都医科大学附属北京朝阳医院-北京呼吸病研究所,北京市100020

出　　处：《中华护理杂志》2009年第5期435-437,共3页Chinese Journal of Nursing

基　　金：首都医学发展科研基金资助项目(2007-1028);中华医学会临床医学慢性呼吸道疾病科研专项基金资助项目(07010090017)

摘　　要：目的探讨健康教育结合规律锻炼是否可以改善慢性阻塞性肺疾病(COPD)稳定期患者的心肺功能,提高运动耐力。方法对38例COPD稳定期患者实施健康教育及规律锻炼。实施教育及锻炼前后,分别对患者进行呼吸困难自我感觉评定(采用改良的Brog量表)、静息肺功能检查、6min步行试验(6MWT)及心肺运动试验(CPET),评价教育及锻炼前后上述参数的变化。结果健康教育及康复训练后,Brog呼吸困难评分较训练前未见明显改善(P>0.05);第1秒用力呼气容积/用力肺活量(FEV1/FVC)及第1秒用力呼气容积与训练前比较未见明显差异(P>0.05);患者6MWT距离增加(P<0.01);CPET中最大功率增加(P<0.01),最大功率下通气量增加(P<0.05)、呼吸储备下降(P<0.05)、呼吸困难指数上升(P<0.05),最大功率下千克摄氧量、氧脉、心率、心率储备较训练前未见明显差异(P>0.05)。结论健康教育结合规律锻炼,能提高COPD稳定期患者心肺功能及运动耐力。Objective To reveal the effects of health education combined with rehabilitation exercise on the lung function and exercise capacity of patients with stable chronic obstructive pulmonary disease（COPD）. Methods Health education were carried out in 38 patients with stable COPD,included knowledge about diseases,nutrition guidance and rehabilitation exercise. Before and after the implementation of education and rehabilitation exercise,the sense of dyspnea were evaluated by the modified scale Brog,resting pulmonary function tests,6-minute walking test（6MWT） and cardiopulmonary exercise test（CPET） were conducted respectively. Results After health education and rehabilitation training,no difference was found either in the score Brog（P〉0.05） or FEV1/FVC and FEV,（P〉0.05） compared with the parameters before health education and rehabilitation training ; but 6MWT distance （6MWD） increased significantly （532.03±62.89 vs 486.69±64.16, P〈0.01 ） ; the maximum power （Wmax）in CPET increased significanfly（91.19±22.08 vs 83.76±21.89,P〈0.01）;VE in condition of Wmax increased significantly （39.51±10.18 vs 37.59±9.79,P〈0.05）; reserve breathing （BR） declined significantly （22.40±19.22 vs 29.07±14.39,P〈0.05）, dyspnea index（DI） increased significantly（0.93±0.17 vs 0.86±0.19,P〈0.05）,and no differences were found in oxygen uptake in the condition of Wmax（VO2/kg）, oxygen pulse（VO2/HR）, heart rate（HR）, heart rate reserve（HRR） compared with the parameters before health education and rehabilitation training （P〉0.05）. Conclusion Health education and rehabilitation exercise can improve heart and lung function of patients with stable COPD and improve their exercise capacity.

关 键 词：健康教育 呼吸锻炼 康复护理 肺疾病 慢性阻塞性 

分 类 号：R473.5[医药卫生—护理学]