慢性阻塞性肺疾病急性加重期进行呼吸康复对健康相关生存质量变化的影响  

Effects of pulmonary rehabilitation on health-related quality of life for patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：何梅[1] 于素娥 洪光朝[1] 杨忠民[1] 吕寒静[1] 邱忠民[1] HE Mei;YU Su＇e;HONG Guangcao(Department of Respiratory Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, 20006)

机构地区：[1]同济大学附属同济医院呼吸内科,上海市200065

出　　处：《中国康复医学杂志》2018年第6期636-641,共6页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然科学基金项目(81200044);上海市浦江人才计划(12pJ1407800);中国高等学校博士学科点专项科研基金项目(20120072120070)

摘　　要：目的:了解呼吸康复对慢性阻塞性肺疾病急性加重期患者健康状况的影响。方法:研究对象为2011年12月—2013年12月在同济大学附属同济医院呼吸科住院的慢性阻塞性肺疾病急性加重的患者共101例,随机分为接受呼吸康复组(康复组)或常规治疗组(对照组)。入院后呼吸康复组进行呼吸康复前评估,制定康复方案、进行康复锻炼、出院前再次评估,通过与对照组对比来评价呼吸康复对患者运动能力和生存质量的影响。结果:康复组呼吸康复前后的6min步行试验得到改善,从242.0±15.03m提高到291.0±14.61m(P=0.001),而对照组6min步行试验从263.9±20.75m改善到273.7±20.03m(P=0.620)。呼吸康复实施后的生存质量评分即慢性呼吸系统疾病标准自测问卷的呼吸困难、疲劳、情绪障碍和疾病控制得分明显高于康复前(P<0.001),而对照组的评分无显著提高。结论:对慢性阻塞性肺疾病急性加重期患者入院后实行呼吸康复可以改善健康状况,结果可为临床医生对慢性阻塞性肺疾病急性加重期患者甚至重症患者及时实施康复计划提供了依据。Objective： To investigate the effect of pulmonary rehabilitation （PR） on health-related quality of life for patients with acute exacerbation of chronic obstructive pulmonary disease （COPD）. Method： A total of 101 acute exacerbation of COPD patients were recruited from the Department of Respiratory Medicine, Tongji Hospital, Tongji University School of Medicine from December 2011 to December 2013. These patients were randomized to receive either pulmonary rehabilitation （rehabilitation group, PR group） or routine care （control group）. PR group followed a standard operation procedure of pulmonary rehabilitation program. To assess the effect of exercise capacity and the health-related quality of life in these two groups, the measurements was compared between baseline and at the day of discharge. Result：The 6MWD significantly improved after PR as compared to that at baseline （242.0±15.03m vs. 291.0±14.61m, P=0.001）, it increased from 263.9±20.75m to 273.7±20.03m （P=0.620） in control group. In addition, there was greater improvement in the self-administered standardized chronic respiratory disease questionnaire（CRQ-SAS） sub-scale of dyspnea, fatigue, emotion and mastery. Conclusion： This study provided preliminary evidence that rehabilitation program had great improvement in health-related quality of life for patients with an acute exacerbation of COPD admitted to hospital. This study would alert clinicians to promptly take rehabilitation program for exacerbation or severe COPD patients.

关 键 词：慢性阻塞性肺疾病 急性加重期 呼吸康复 健康相关生存质量 慢性呼吸系统疾病标准自测问卷评分 

分 类 号：R563.3[医药卫生—呼吸系统] R493[医药卫生—内科学]