肺康复对中重度慢性阻塞性肺疾病患者运动耐力和生活质量的影响  

The effects of pulmonary rehabilitation on the hospitalization rates and exercise endurance of patients with moderate or severe chronic obstructive pulmonary disease

作　　者：陈贵华[1] 周向东[1] 虞乐华[1] 刘益群[1] 李琪[1] 

机构地区：[1]重庆医科大学附属第二临床医院呼吸内科,重庆400010

出　　处：《中华物理医学与康复杂志》2012年第6期444-447,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：基金项目：重庆市卫生局医学科技项目（2009-2-176）;重庆医科大学医学研究课题（XBYB2008026）;重庆市科技攻关项目（2010-5092）

摘　　要：目的观察运动疗法结合健康教育的肺康复对中重度慢性阻塞性肺疾病（COPD）患者运动耐力和生活质量的影响。方法选取2009年1月至2010年6月在我院呼吸内科住院的中重度COPD稳定期患者86例，按随机数字表法分为观察组（n=46例）和对照组（n=40例），2组患者均进行呼吸内科常规治疗，观察组在此基础上增加运动疗法和健康教育相结合的肺康复治疗，对照组仅通过电话随访进行健康宣教和康复训练指导。记录2组患者入组前1年和入组1年后的平均复发住院次数、住院时间和入组患者总卧床时间，并评价其人组前1年和人组1年后的6min步行距离（6MWD）和生活质量。结果入组前1年，2组患者的年平均复发住院次数、住院时间和入组患者总卧床时间组间比较，差异无统计学意义（P〉0．05）；入组1年后，观察组的年平均复发住院次数、住院时间和入组患者总卧床时间分别为（2．03±0．89）次、（12．8±1．5）d和（456±68）d，与组内治疗前比较，差异有统计学意义（P〈0．05），同时与对照组的（3．63±0．82）次、（14．4±1．5）d和（539±69）d比较，差异亦有统计学意义（P〈0．05）。入组前1年，2组患者的6MWD和生活质量评分组间比较，差异无统计学意义（P〉0．05）；入组1年后，观察组的6MWD和生活质量评分均显著改善，与组内入组前1年和对照组入组1年后比较，差异均有统计学意义（P〈0．05）。结论长期运动疗法结合健康教育的肺康复不仅可以增强COPD患者的运动耐力，还可改善其生活质量，减轻其经济负担。Objective To investigate the effects of exercise therapy and health education on the hospitalization and exercise endurance of patients with moderate or severe chronic obstructive pulmonary disease （COPD）. Methods A total of 86 patients with moderate or severe but stable COPD were divided randomly into an observation group （ n = 46） and a control group （ n = 40）. The patients in both groups accepted general respiratory medical therapy. The patients in the observation group also accepted additional pulmonary rehabilitation therapy which consisted of exercise and health education while the patients in the control group only accepted health education and rehabilitation training guidance by telephone instead of standardized pulmonary rehabilitation therapy. The average recurrence of hospitalization, length of stay, and total bed time of all of the patients was tracked for a year before and after enrolment. Their 6 minute walking distance （6MWD） and quality of life （QOL） as reflected by using a scale recommended by the Chinese Society of Respiratory Disease before and after entering the study were evaluated. Results There was no significant difference between the groups in the year before entering the study in terms of their average frequency of hospitalization, length of stay or total bed time. In the year after enrollment average frequency of recurrence requiring hospitalization, length of stay and total bed time in the observation group all decreased significantly compared with the previous year, and all were significantly lower than in the control group. There were no significant differences between the groups in average 6MWD or average QOL score at entry, but in the subsequent year both groups＇ results improved significantly. Conclusion Long term pulmonary rehabilitation can not only enhance exercise endurance, it also improves QOL and relieves the economic burden of COPD patients on society.

关 键 词：肺疾病 慢性阻塞性 运动疗法 健康教育 住院 运动耐力 

分 类 号：R563.9[医药卫生—呼吸系统]