短期肺康复对慢性阻塞性肺疾病急性加重住院患者运动能力和生活质量的影响

M. Ali, D. Talwar, S. Jain
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引用次数: 26

摘要

最近的研究表明,慢性阻塞性肺疾病(AECOPD)急性加重期患者的肺康复(PR)方案可以减轻呼吸困难,提高运动能力,并预防进一步加重的发生。目的评价3周PR计划在AECOPD患者中的应用价值。方法入院的AECOPD患者在呼吸重症监护病房(RICU)临床稳定后,交替进行干预(n=15);和对照组(n=15)。基线评估包括肺活量测定、6分钟步行试验(6MWT)、症状受限心肺运动试验(CPET)、健康相关生活质量(HRQoL)评估(通用问卷)医学结局研究简短问卷(s - f36)和Borg评分评估呼吸困难。干预组患者在常规护理的基础上进行PR运动,包括步行、自行车几何和阻力运动各20分钟,每周3次,持续3周。对照组患者仅接受常规护理。出院后,在门诊基础上隔天继续治疗,共三周。三周后,两组都重复了这项评估。结果9次PR运动对AECOPD患者的总体幸福感、第一秒用力呼气量(FEV1)、6MWT参数、运动能力、峰值摄氧量和耗氧量(VO2)/ CPET瓦特斜率均有统计学意义的改善。结论短期PR方案对AECOPD的治疗有一定的帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of a short-term pulmonary rehabilitation on exercise capacity and quality of life in patients hospitalised with acute exacerbation of chronic obstructive pulmonary disease.
BACKGROUND Recent research shows that pulmonary rehabilitation (PR) programmes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), reduced dyspnoea, improved exercise capacity, and prevented occurrence of further exacerbations. OBJECTIVE To evaluate the utility of a 3-week PR programme in patients with AECOPD. METHODS Patients admitted with AECOPD, following clinical stabilisation in the respiratroy intensive care unit (RICU), were alternately assigned to intervention (n=15); and control groups (n=15), respectively. Baseline assessment included spirometry, six-minute walk test (6MWT), symptom limited cardiopulmonary exercise test (CPET), health-related quality of life (HRQoL) assessment by generic questionnaire medical outcomes study short form (S-F 36) questionnaire and dyspnoea evaluation by Borg score. The intervention group patients were treated with usual care plus PR exercises in the form of 20 minutes each of walking, bicycle ergometry and resistance exercises, thrice-weekly for three weeks. The control group patients were treated with only the usual care. After discharge from hospital the treatment regimens were continued on alternate days on outpatient basis, for a total of three weeks. The assessment was repeated in both the groups after three weeks. RESULTS Nine sessions of PR exercises produced statistically significant improvement in general well-being, forced expiratory volume in the first second (FEV1), 6MWT parameters, exercise capacity, peak oxygen uptake and volume of oxygen consumption (VO2)/Watts slope on CPET in patients with AECOPD. CONCLUSION Short duration PR programmes appear to be helpful in the management of AECOPD.
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