急性加重期慢性阻塞性肺疾病患者肺康复治疗效果评价  

The value of pulmonary rehabilitation in patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：钱红玉[1] 王玉珍[1] 李毅[1] 

机构地区：[1]天津市胸科医院呼吸与危重症医学科,300222

出　　处：《天津医药》2015年第10期1201-1204,共4页Tianjin Medical Journal

摘　　要：目的观察急性加重期慢性阻塞性肺疾病(AECOPD)患者行早期肺康复治疗的效果。方法将97例AECOPD住院患者随机分为急性期康复组(58例)和对照组(39例)。2组患者均在急性期症状好转及急性期感染控制后(T1)进行基线评估,急性期康复组立即行12周(T2)肺康复训练;对照组在此期间仅接受常规药物治疗及肺康复宣教而未参与肺康复训练,至症状缓解并维持稳定12周(T2)进行第2次基线评估,后开始进行12周(T3)肺康复训练。观察肺功能指标、6 min步行距离(6MWD)、呼吸困难评分(MRC)及慢性阻塞性肺疾病评估测量(CAT)评分的变化。结果 2组肺功能各指标在不同时点间差异均无统计学意义;急性期康复组T1时的肺功能各指标与对照组T1时比较,T2时分别与对照组T2、T3时的比较差异均无统计学意义。对照组T3时的6MWD均高于T1、T2,MRC、CAT均低于T1、T2(均P<0.05),各指标在T1与T2时的差异均无统计学意义;急性期康复组T2时的6MWD明显高于T1,MRC、CAT均明显低于T1(均P<0.05)。T1时2组间各指标差异均无统计学意义,急性期康复组T2时的6MWD均分别高于T2、T3时的对照组,MRC、CAT均分别低于T2、T3时的对照组(均P<0.05)。结论 AECOPD行早期肺康复治疗可以更早提高患者活动能力,降低呼吸困难程度,提高生活质量。Objective To observe the effect of early pulmonary rehabilitation （PR） on patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods AECOPD patients （n=97） were randomly distributed into two groups：control group （n=39） and rehabilitation group （n=58）. Patients in both groups were assessed when symptom im-proved from acute phase （baseline, T1）. Then patients in control group only received pharmaco-therapy and rehabilitation ed-ucation without PR. When symptom was relieved and stable （T2）, they were given 12 weeks PR （T3）. On the other hand, pa-tients in rehabilitation group underwent a 12-week PR after T1 directly （T2）. The lung function parameters, 6 min walking distance （6MWD）, MRC scores and CAT scores were observed and analyzed in two groups. Results Until the end of the 12-weeks observation, the value of lung function showed no statistic differences between two groups（either T1 in control group vs T1 in PR group or T2 in PR group vs T2 and T3 in control group. In control group, the value of 6MWD scores of T3 was bet-ter than that of T1 and T2, in PR group（F6MWD=8.762,FMRC=4.432,FCAT=10.266,P〈0.05）while MRC, CAT value in T3 of control group were higher than those in T1 and T2 of PR group. At T1, parameters does not demonstrate significant difference between these two groups. Value of 6MWD was higher while MRC and CAT were lower in T2 of PR group than that in T2 and T3 of control group. Conclusion Early pulmonary rehabilitation could improve the mobility and qulity of life, as well as ameliorate the severity of dyspnea in AECOPD patients.

关 键 词：肺疾病 慢性阻塞性 肺康复 急性加重 6分钟步行距离 CAT评分 

分 类 号：R563.3[医药卫生—呼吸系统]