阶梯式运动康复在老年慢性阻塞性肺疾病临床稳定期患者中的应用  

Application of stepwise exercise rehabilitation in elderly patients with stable chronic obstructive pulmonary disease

作　　者：彭爱君 朱迎钢[2] 许银苹 张华 Peng Aijun;Zhu Yinggang;Xu Yinping;Zhang Hua(Department of Respiratory Medicine,Zhongren Geriatric Nursing Hospital,Jinshan District,Shanghai,201501,P.R.China;Department of Respiratory and Critical Care Medicine,Huadong Hospital,Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]上海市金山区众仁老年护理医院呼吸内科,上海201501 [2]复旦大学附属华东医院呼吸与危重症医学科,上海200040

出　　处：《老年医学与保健》2024年第1期155-158,163,共5页Geriatrics & Health Care

基　　金：金山区医药卫生科技创新资金项目(2022-WS-30)。

摘　　要：目的探讨基于慢性阻塞性肺疾病(COPD)全球倡议分级的阶梯式运动康复对老年COPD稳定期患者肺功能、运动耐力及急性加重事件的影响。方法选取上海市金山区众仁老年护理医院住院康复治疗的43例老年COPD稳定期患者,随机分为研究组(阶梯式运动康复)22例和对照组(传统运动康复)21例。干预8周后,对比分析2种训练方案对老年COPD稳定期患者第1秒用力呼气容积占预计值百分比(FEV_1%pred)、COPD评估测试(CAT)、6 min行走距离(6MWD)及急性加重事件的影响。结果与同组干预前相比,研究组干预后的CAT评分降低,6MWD增加(均P<0.001)。与对照组相比,研究组急性加重事件较少(28.57%vs 4.55%,P=0.033)。2组干预前后FEV_1%pred差值差异无统计学意义(P=0.565)。结论阶梯式运动康复一定程度上能改善步行距离和运动耐力,还能减少急性加重事件的发生。Objective To investigate the effects of stepwise exercise rehabilitation based on the Global Initiative for Chronic Obstructive Lung Disease(GOLD)Grading on pulmonary function,exercise tolerance,and acute exacerbation in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods Forty-three elderly patients with stable COPD who were hospitalized for rehabilitation in Zhongren Geriatric Nursing Hospital in Jinshan District were randomly divided into study group(stepwise exercise rehabilitation,n=22)and control group(traditional exercise rehabilitation,n=21).After 8 weeks of intervention,the effects of the two training methods on forced expiratory volume in 1 second as a percentage of predicted value(FEV 1%pred),COPD assessment test(CAT),6-minute walking distance(6MWD),and acute exacerbation events were compared and analyzed.Results Compared with the same group before intervention,CAT score decreased and 6MWD increased in the study group after intervention(all P<0.001).Compared with the control group,the study group had fewer acute exacerbation events(28.57%vs 4.55%,P=0.033).There was no significant difference in the difference of FEV 1%pred before and after intervention between the two groups(P=0.565).Conclusion Stepwise exercise rehabilitation can improve walking distance and exercise tolerance to a certain extent,and also reduce the occurrence of acute aggravation events.

关 键 词：老年人 慢性阻塞性肺疾病 阶梯式运动康复 运动耐力 急性加重 

分 类 号：R473.5[医药卫生—护理学]