医联体内肺康复治疗模式对慢阻肺患者生活质量的综合疗效观察  

Observation on the effect of pulmonary rehabilitation on the quality of life in patients with Chronic Obstructive Pulmonary Disease in the Medical Association

作　　者：管超[1] 茅俊杰[1] 黄洁 李擎[2] 余荣环[1] 王葆青 张颖[2] GUAN Chao;MAO Junjie;HUANG Jie;LI Qing;YU Ronghuan;WANG Baoqing;ZHANG Ying(Department of respiratory and critical care,Shanghai Xuhui District Central Hospital,Shanghai 200231,China;Department of Rehabilitation,Shanghai Xuhui District Central Hospital,Shanghai 200231,China)

机构地区：[1]上海市徐汇区中心医院呼吸与危重症学科,上海200231 [2]上海市徐汇区中心医院康复科,上海200231

出　　处：《临床肺科杂志》2025年第4期570-575,共6页Journal of Clinical Pulmonary Medicine

基　　金：上海市徐汇区医学科技重大项目(SHXH201646);上海市徐汇区卫生健康系统高峰学科建设资助项目(SHXHZDXK202312)。

摘　　要：目的探讨医联体内肺康复治疗模式对稳定期慢阻肺患者的运动能力、生活质量、营养、心理等综合状态的临床疗效。方法对中山-徐汇医联体内于2018年1月-2023年1月收治的56例慢阻肺患者,采用随机数字表法分为观察组和对照组:对照组予以规范基础治疗(慢阻肺诊疗常规);观察组在规范基础治疗外,增加中山-徐汇医联体内肺康复治疗(功率自行车运动、呼吸方式康复训练)。12周治疗后对两组进行疗效评定。以运动能力(FEV 1%预计值、6分钟步行距离、峰值摄氧量)为主要观察项目,生活质量问卷(CAT、mMRC、SGRO)、下肢肌肉状态、营养、心理状态为次要评价指标。结果12周治疗后,观察组运动能力评价指标FEV 1%预计值、6分钟步行距离、峰值摄氧量的改善程度(治疗前后差值)显著优于对照组(P<0.05);观察组生活质量评价指标CAT、mMRC、SGRQ评分治疗后较治疗前降低,降低程度显著优于对照组(P<0.05)。观察组下肢肌肉含量、力量及耐力经12周治疗后较对照组均有显著提高(P<0.05)。结论慢阻肺患者通过医联体内肺康复治疗模式干预后,运动能力提升、下肢肌肉质量提高、生活状态改善,该模式有效且值得推广。Objective To investigate the clinical effect of pulmonary rehabilitation on the exercise ability,quality of life,nutrition,psychology,and other comprehensive states of stable COPD patients in Xuhui Medical Consociation.Methods 56 COPD patients admitted to the Zhongshan-Xuhui Medical Association from January 2018 to January 2023 were randomly paired and divided into an observation group and a control group.The control group received standardized basic treatment(conventional diagnosis and treatment of COPD);In addition to standardized basic treatment,the observation group added Zhongshan Xuhui Medical Joint Body pulmonary rehabilitation therapy(power cycling exercise,respiratory rehabilitation training).After 12 weeks of treatment,the clinical effect of the two groups was evaluated.The main observation items were motor ability(FEV 1%predicted value,6-minute walking distance,peak oxygen uptake)and quality of life questionnaire(CAT,mMRC,SGRO),with lower limb muscle status,nutrition,and psychological status as secondary evaluation indicators.Results After 12-weeks-treatment,the improvement in exercise capacity evaluation indicators FEV 1%predicted value,6-minute walking distance,peak oxygen uptake(difference before and after treatment)in the observation group was significantly better than that in the control group(P<0.05);the life evaluation indicators CAT,mMRC,and SGRQ scores in the observation group were lower after treatment than before,and the degree of reduction was better than that in the control group(P<0.05).The lower limb muscle mass and strength in the observation group were significantly higher than those in the control group(P<0.05).Conclusion After adopting pulmonary rehabilitation treatment in the Xuhui Medical Consociation,COPD patients could improve their exercise ability,muscle quality,and living conditions,which is an effective and scalable treatment model.

关 键 词：医联体 慢性阻塞性肺疾病 生活质量 

分 类 号：R563.9[医药卫生—呼吸系统] R493[医药卫生—内科学]