肺康复治疗在慢性阻塞性肺疾病急性加重期中的应用  

Pulmonary Rehabilitation for Acute Exacerbations of Chronic Obstructive Pulmonary Disease

作　　者：黄潘文[1] 文红[1] 张平[1] 

机构地区：[1]东莞市人民医院呼吸科,广东东莞523000

出　　处：《实用临床医学（江西）》2015年第7期4-6,29,共4页Practical Clinical Medicine

基　　金：东莞市科技计划医疗卫生类科研一般项目(201210515001104)

摘　　要：目的探讨适合于急性加重期慢性阻塞性肺疾病(COPD)的肺康复治疗方法,对其有效性、可行性、安全性进行评价。方法将48例COPD急性加重期患者按随机数字表法分为康复组与对照组,每组24例。2组均行抗感染、化痰、平喘及对症支持治疗,康复组在对症支持治疗基础上行肺康复治疗(包括健康教育、运动康复)。比较2组治疗前后肺功能、运动能力与生活质量的变化情况。肺功能指标包括:1s用力呼气容积(FEV1)、用力肺活量(FVC)、FVC占预计值百分率、FEV1占预计值百分率及最大呼吸量(MVV);运动能力指标为6 min步行距离(6MWD);生活质量采用圣·乔治呼吸疾病问卷(SGRQ)进行评价。结果康复组完成试验18例;对照组完成试验19例。2组肺功能各项指标治疗前后比较差异均无统计学意义(P>0.05);治疗后康复组6MWD值较对照组显著增加,SGRQ评分较对照组显著下降(P<0.05)。结论急性加重期COPD采用肺康复治疗可获得运动能力及生活质量的显著改善,采用BORG呼吸困难指数掌握运动强度的急性加重期COPD肺康复方案安全可行。Objective To evaluate the availability,feasibility and safety of pulmonary rehabili-tation in the treatment of acute exacerbations of chronic obstructive pulmonary disease(COPD). Methods Forty-eight patients with acute exacerbations of COPD were randomly divided into re-habilitation group and control group.All patients were treated with anti-infection,phlegm elimi-nation,expectorant and symptomatic and supportive treatment.In addition,the rehabilitation group was given pulmonary rehabilitation(including health education and exercise rehabilitation). The pulmonary function,motor ability and quality of life were measured before and after treat-ment.The pulmonary function indexes included forced expiratory volume in one second(FEV1), forced vital capacity(FVC),FVC percentage predicted(FVC % pred),FEV1 percentage predicted (FEV1 % pred)and maximal voluntary ventilation(MVV).The motor ability was assessed by 6-minute walking distance(6MWD).The quality of life was assessed by St George’s respiratory questionnaire(SGRQ).Results Eighteen patients in rehabilitation group and 19 patients in con-trol group completed the test.No obvious changes in all indexes were found in both groups after treatment(P >0.05).Compared with control group,pulmonary rehabilitation induced an increase in 6MWD and a decrease in SGRQ score(P <0.05).Conclusion Pulmonary rehabilitation with the use of Borg dyspnea index for mastering the exercise intensity is a safe and feasible treatment, which can significantly improve motor ability and quality of life in patients with acute exacerba-tions of COPD.

关 键 词：急性加重期慢性阻塞性肺疾病 肺康复治疗 肺功能 运动能力 生活质量 

分 类 号：R563[医药卫生—呼吸系统]