呼吸康复在间质性肺疾病患者中的综合管理  

Comprehensive management of pulmonary rehabilitation in patients with interstitial lung disease

作　　者：代晓清 杨国莉[1] 孟婕 Dai Xiaoqing;Yang Guoli;Meng Jie(Department of Respiratory and Critical Care Medicine,the Third Xiangya Hospital of Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院呼吸与危重症医学科,长沙410013

出　　处：《国际呼吸杂志》2023年第11期1352-1356,共5页International Journal of Respiration

基　　金：国家自然科学基金(82070070、82270079)。

摘　　要：间质性肺疾病(ILD)是一组以肺间质(包括支气管壁、血管和肺泡周围的结缔组织)损伤和炎症为特征的限制性肺部疾病,包含200多种疾病。其共同病理特征是炎症和纤维化。影响ILD患者生活质量的因素可分为肺内因素和肺外因素,肺内因素主要指肺部炎症和纤维化引起的呼吸功能受损,肺外因素包括肺外症状、运动能力、行为(如吸烟)、社交隔离、经济负担和心理状态等。在治疗ILD患者时,除了针对肺内因素的治疗(抗炎、止咳、抗纤维化等治疗)外,还需要考虑肺外因素的干预。呼吸康复是一种安全、有效、经济实惠的综合性干预手段,可以帮助ILD患者减轻呼吸困难和疲劳,提高活动能力,减少焦虑抑郁,从而提高生活质量。本文探讨呼吸康复对ILD患者的益处,介绍呼吸康复在ILD患者中的综合管理,以及实施呼吸康复面临的难题。Interstitial lung disease(ILD)is a group of restrictive lung diseases characterized by injury and inflammation of pulmonary interstitium,including the bronchial wall,blood vessels and connective tissue around alveoli.It contains more than 200 kinds of diseases,and their common pathological features are inflammation and fibrosis.The factors affecting the quality of life of ILD patients can be classified into intrapulmonary and extrapulmonary.The former mainly includes the impairment of respiratory function caused by pulmonary inflammation and fibrosis,and the latter includes extrapulmonary symptoms,exercise ability,behaviors(such as smoking),social isolation,economic burden,psychological status,etc.In addition to the treatment of intrapulmonary factors(anti-inflammatory,antitussive,anti-fibrosis,etc.),it is also necessary to consider the intervention of extrapulmonary factors.Pulmonary rehabilitation is a safe,effective and economical comprehensive intervention,which may alleviate dyspnea,fatigue,anxiety and depression,and improve the activity ability and the quality of life of ILD patients.This review discusses the benefits of pulmonary rehabilitation for ILD patients,introduces the comprehensive management of pulmonary rehabilitation technology in ILD patients,and the difficulties in the implementation of pulmonary rehabilitation.

关 键 词：肺疾病 间质性 运动 心理社会干预 生活质量 呼吸康复 

分 类 号：R563[医药卫生—呼吸系统] R493[医药卫生—内科学]