[1]石媛娟,刘卫庭,姚 宇.早期肺康复对慢性阻塞性肺疾病不同级别急性加重期患者的影响[J].医学信息,2021,34(19):76-80.[doi:10.3969/j.issn.1006-1959.2021.19.019]
 SHI Yuan-juan,LIU Wei-ting,YAO Yu.Effect of Early Pulmonary Rehabilitation on Patients with Different Gradesof Acute Exacerbation Chronic Obstructive Pulmonary Disease[J].Medical Information,2021,34(19):76-80.[doi:10.3969/j.issn.1006-1959.2021.19.019]
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早期肺康复对慢性阻塞性肺疾病不同级别急性加重期患者的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年19期
页码:
76-80
栏目:
论著
出版日期:
2021-10-01

文章信息/Info

Title:
Effect of Early Pulmonary Rehabilitation on Patients with Different Gradesof Acute Exacerbation Chronic Obstructive Pulmonary Disease
文章编号:
1006-1959(2021)19-0076-05
作者:
石媛娟1刘卫庭1姚 宇2
南华大学附属邵阳市中心医院呼吸与危重症医学科1,康复科2,湖南 邵阳 422000
Author(s):
SHI Yuan-juan1LIU Wei-ting1YAO Yu2
Department of Respiratory and Critical Care Medicine1,Department of Rehabilitation Medicine2,Shaoyang Central HospitalAffiliated to South China University,Shaoyang 422000,Hunan,China
关键词:
慢性阻塞性肺疾病肺康复动脉血气分析肺功能运动耐力
Keywords:
Chronic obstructive pulmonary diseasePulmonary rehabilitationArterial blood gas analysisPulmonary functionExercise endurance
分类号:
R563
DOI:
10.3969/j.issn.1006-1959.2021.19.019
文献标志码:
A
摘要:
目的 探讨早期肺康复对慢性阻塞性肺疾病(COPD)不同级别急性加重患者的影响。方法 选取2019年8月-2021年2月于我院就诊的因非细菌感染导致的COPD急性加重(AECOPD)患者120例,依据严重程度分为1组、2组,各60例,并按照随机数字表法分成治疗一组、治疗二组与治疗三组,各20例。所有患者均按照COPD诊疗指南给予常规治疗,治疗一组入院后第7天开始肺康复训练,治疗二组入院后第14天开始肺康复训练,治疗三组入院后第30天开始肺康复训练。比较患者肺功能、CAT评分、6MWD及动脉血气。结果 各组治疗后FVC、FEV1水平均高于治疗前,差异有统计学意义(P<0.05),1组及2组中,治疗一组FVC、FEV1水平高于治疗二组及治疗三组,差异有统计学意义(P<0.05),治疗二组FVC、FEV1水平高于治疗三组,差异有统计学意义(P<0.05)。各组治疗后CAT评分低于治疗前,6MWD高于治疗前,差异有统计学意义(P<0.05),1组及2组中,治疗一组CAT评分低于治疗二组及治疗三组,6MWD高于治疗二组及治疗三组,差异有统计学意义(P<0.05),治疗二组CAT评分低于治疗三组,6MWD高于治疗三组,差异有统计学意义(P<0.05)。在2组中,各组治疗后PaO2水平均高于治疗前,PaCO2水平低于治疗前,差异有统计学意义(P<0.05),各组间PaO2、PaCO2水平比较,差异无统计学意义(P>0.05)。结论 COPD急性加重期不同级别患者早期行肺康复有利于缓解呼吸困难症状,改善肺功能,提高运动耐力,但不同级别存在差异。
Abstract:
Objective To explore the effects of early pulmonary rehabilitation on patients with different grades of acute exacerbations of chronic obstructive pulmonary disease(COPD).Methods A total of 120 patients with acute exacerbation of COPD (AECOPD) caused by non-bacterial infection in our hospital from August 2019 to February 2021 were selected and divided into group 1 and group 2 according to the severity, with 60 cases in each group. And according to the random number table method, they were divided into treatment group 1, treatment group 2 and treatment group 3, with 20 cases in each group. All patients were given conventional treatment according to the COPD diagnosis and treatment guidelines, the treatment group 1 was started the pulmonary rehabilitation training on the 7th day after admission, the treatment group 2 was started the pulmonary rehabilitation training on the 14th day after admission, and the treatment group 3 was started the pulmonary rehabilitation training on the 30th day after admission, the pulmonary function, CAT score, 6MWD and arterial blood gas were compared.Results After treatment, the levels of FVC and FEV1 in each group were higher than those before treatment, and the difference was statistically significant (P<0.05); the levels of FVC and FEV1 in the treatment group 1 were higher than those in the treatment group 2 and the treatment group 3 between group 1 and group 2, and the difference was statistically significant (P<0.05); the levels of FVC and FEV1 in the treatment group 2 were higher than those in the treatment group 3, and the difference was statistically significant (P<0.05). The CAT score of each group after treatment was lower than that before treatment, and 6MWD was higher than that before treatment, and the difference was statistically significant (P<0.05); the CAT score in the treatment group 1 was lower than that in the treatment group 2 and the treatment group 3, and 6MWD was higher than that in the treatment group 2 and the treatment group 3 between group 1 and group 2, the difference was statistically significant (P<0.05); the CAT score in the treatment group 2 was lower than that in the treatment group 3, and 6MWD was higher than in the treatment group 3, the difference was statistically significant (P<0.05). In group 1 and group 2, after treatment, PaO2 level in each group was higher than that before treatment, PaCO2 level was lower than that before treatment, and the difference was statistically significant (P<0.05), while there was no significant difference in PaO2 and PaCO2 levels between three groups(P>0.05).Conclusion Early pulmonary rehabilitation for patients with different grades of acute exacerbation of COPD is beneficial to relieve symptoms of dyspnea, improve pulmonary function and exercise endurance, but there were differences in different grades.

参考文献/References:

[1]Singh D,Agusti A,Anzueto A,et al.Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019[J].Eur Respir J,2019,53(5):1900164.[2]中华医学会呼吸病学分会慢性阻塞性肺疾病学组,中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会.慢性阻塞性肺疾病诊治指南(2021年修订版)[J].中华结核和呼吸杂志,2021,44(3):170-205.[3]徐巧巧,肖艳红.肺康复训练对慢性阻塞性肺疾病稳定期患者的疗效观察[J].中国康复,2019,34(1):14-17.[4]Janaudis-Ferreira T,Tansey CM,Harrison SL,et al.A Qualitative Study to Inform a More Acceptable Pulmonary Rehabilitation Program after Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J].Ann Am Thorac Soc,2019,16(9):1158-1164.[5]顾为丽,陈荣昌.呼吸训练在慢性阻塞性肺疾病患者康复治疗中的应用[J].中华结核和呼吸杂志,2012,35(12):946-948.[6]Mayer AF,Karloh M,Dos Santos K,et al.Effects of acute use of pursed-lips breathing during exercise in patients with COPD: a systematic review and meta-analysis[J].Physiotherapy,2018,104(1):9-17.[7]李艳娇,史铁英,刘启贵.无支撑上肢锻炼对慢性阻塞性肺疾病患者的康复效果[J].中国康复理论与实践,2016,22(6):719-723.[8]郑敏,张丽,甘秀妮.COPD急性加重期实施主动呼吸循环技术联合体位引流干预的可行性研究[J].重庆医学,2017,46(35):5011-5013.[9]Jones PW,Harding G,Berry P,et al.Development and first validation of the COPD Assessment Test[J].Eur Respir J,2009,34(3):648-654.[10]Li Y,Yang L,Wang L,et al.Burden of hypertension in China: A nationally representative survey of 174,621 adults[J].Int J Cardiol,2017(227):516-523.[11]Xu Y,Wang L,He J,et al.Prevalence and control of diabetes in Chinese adults[J].JAMA,2013,310(9):948-959.[12]Fang L,Gao P,Bao H,et al.Chronic obstructive pulmonary disease in China: a nationwide prevalence study[J].Lancet Respir Med,2018,6(6):421-430.[13]Spruit MA,Gosselink R,Troosters T,et al.Muscle force during an acute exacerbation in hospitalised patients with COPD and its relationship with CXCL8 and IGF-I[J].Thorax,2003,58(9):752-756.[14]许轶明,沈宏华,杜井波,等.慢性阻塞性肺疾病患者预后影响因素分析及肺康复疗效[J].康复学报,2019,29(6):21-27.[15]Puhan MA,Spaar A,Frey M,et al.Early versus late pulmonary rehabilitation in chronic obstructive pulmonary disease patients with acute exacerbations: a randomized trial[J].Respiration,2012,83(6):499-506.[16]刘卫庭,姚宇.早期肺康复对慢性阻塞性肺疾病急性加重期患者肺功能及运动耐力的影响[J].中华物理医学与康复杂志,2019,41(3):213-216.[17]李琴,陈贵华,虞乐华,等.肺康复治疗慢性阻塞性肺疾病急性加重期疗效的系统评价[J].中华物理医学与康复杂志,2019,41(4):299-304.[18]He M,Yu S,Wang L,et al.Efficiency and safety of pulmonary rehabilitation in acute exacerbation of chronic obstructive pulmonary disease[J].Med Sci Monit,2015(21):806-812.[19]Gao LZ,Zhao HM.A nationwide online questionnaire survey of the understanding and implementation of pulmonary rehabilitation at all levels of medical institutions in China in 2017[J].Chin J Respir Dis,2019,42(4):275-278.[20]吕晓红,王丽辉,孙红莹,等.从预防急性加重谈慢性阻塞性肺疾病的管理与控制[J].中华结核和呼吸杂志,2020,43(7):629-632.[21]慢性阻塞性肺疾病急性加重(AECOPD)诊治专家组.慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2017年更新版)[J].国际呼吸杂志,2017,37(14):1041-1057.

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更新日期/Last Update: 1900-01-01