摘要
目的 探讨早期肺康复对慢性阻塞性肺疾病急性加重期(AECOPD)老年患者的临床效果。方法 选取2017年6月~2018年6月南京医科大学附属常州第二人民医院呼吸科收治的诊断为AECOPD的老年患者86例,采用随机数表法分为研究组43例和对照组43例,对照组患者入院后均积极对症处理,给予抗感染、解痉平喘、止咳化痰治疗,并根据患者的动脉血气分析结果给予无创机械通气治疗。研究组患者在此基础上给予肺康复干预,共持续治疗3个月。对比两组患者治疗前后的肺功能指标,主要包括用力肺活量(FVC)、第1秒用力呼气容积(FEV1)及FEV1/FVC,同时对比两组患者治疗前后的6 min步行距离(6 MWD)情况、评估生存质量(CAT)评分、呼吸困难指数(MMRC)评分情况。结果 两组患者治疗前的FVC、FEV1及FEV1/FVC水平比较差异均无统计学意义(P>0.05)。治疗后6个月,两组患者的FEV1及FEV1/FVC水平以及研究组患者的FCV水平均有显著提高,且研究组FVC、FEV1及FEV1/FVC水平均显著高于对照组,差异均具有统计学意义(P<0.05)。两组患者治疗前6 MWD结果、CAT及MMRC评分比较差异均无统计学意义(P>0.05),治疗后6个月,两组患者的6 MWD水平均明显提高,CAT及MMRC评分均明显降低,且研究组6 MWD水平显著高于对照组,CAT及MMRC评分显著低于对照组,差异均具有统计学意义(P<0.05)。结论 对于老年AECOPD患者,在患者身体耐受的状态下早期肺康复训练能够显著提高患者的活动能力,降低呼吸困难程度及疾病症状,对改善患者生活质量具有重要价值。
Objective To explore the clinical effect of early lung rehabilitation on elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 86 elderly patients with AECOPD in department of respiratory in our hospital from June 2017 to June 2018 were enrolled and randomly divided into study group(43 cases)and control group(43 cases).After admission,the patients in two groups were all given active symptomatic treatment,including anti-infection,spasmolysis,asthma relief,cough and phlegm relief,and non-invasive mechanical ventilation according to the results of arterial blood gas analysis.The patients in the study group were given pulmonary rehabilitation intervention on this basis for 3 months.Results There was no significant difference in the levels of FVC,FEV1 and FEV1/FVC between the two groups before treatment(P>0.05).After treatment,the levels of FEV1 and FEV1/FVC in the two groups and the levels of FCV in the study group were significantly increased.Also the levels of FVC,FEV1 and FEV1/FVC in the study group were significantly higher than those in the control group 6 months after treatment,and the differences were statistically significant(P>0.05).There was no significant difference in 6 MWD results,CAT and MMRC scores between the two groups before treatment(P>0.05).After treatment,the 6 MWD levels of the two groups were significantly increased,and the scores of CAT and MMRC were significantly decreased.After treatment,the 6 MWD levels of the study group were significantly higher than those of the control group,and the scores of CAT and MMRC were significantly lower than those in the control group(P<0.05).Conclusion For elderly patients with AECOPD,early lung rehabilitation training under the condition of physical tolerance can significantly improve the activity of patients,reduce the degree of dyspnea and disease symptoms,and has important value for improving the quality of life of patients.
作者
方晓明
刘茗
黄燕华
俞丹
史彩雯
Fang Xiaoming;Liu Ming;Huang Yanhua(Department of Respiratory and Critical Care Discipline,Changzhou Second People's Hospital Affiliated to Nanjing Medical University,Changzhou 213000,China)
出处
《中华保健医学杂志》
2019年第6期531-534,共4页
Chinese Journal of Health Care and Medicine
基金
江苏省六大人才高峰基金资助项目（WSN092）
江苏省333高层次人才基金资助项目（BRA2016119）
关键词
慢性阻塞性肺疾病
急性加重期
肺康复
肺功能
Chronic obstructive pulmonary disease
Acute exacerbation
Lung rehabilitation
Lung function
