CAJ | 학술논문

目的观察社区呼吸康复对慢性阻塞性肺疾病(COPD)患者症状及生活质量的影响.方法选取我院门诊及社区COPD患者为研究对象并给予社区呼吸康复干预,治疗内容包括健康教育、用药及营养指导、呼吸训练、运动锻炼等;每4周电话随访1次.于入选时及干预1年后进行疗效评定,疗效观察指标包括肺功能[第一秒用力呼气容积占预计值百分比(FEV1％)、第一秒用力呼气容积与用力肺活量比值(FEV1/FVC％)]、圣乔治呼吸问卷(SGRQ)、医学研究会呼吸困难量表(MRC)及Borg量表、焦虑及抑郁测评、6 min步行试验(6 MWT)、营养状况等.结果共有85例患者纳入最终统计分析.入选COPD患者康复前FEV1％为(48.11 ±14.54)％,康复后为(47.82± 14.94)％,康复前后差异无统计学意义(P＞0.05);6min步行距离从康复前[(416.10 ±99.84)m]增加至[(437.51±116.17)m],康复前后差异具有统计学意义(P ＜0.05);SGRQ评分较康复前平均降低4.8分;急性加重次数由康复前[(1.07±1.27)次]减至[(0.39±0.69)次](P＜0.01).根据疾病严重度分级,中度及重度以上COPD患者SGRQ评分均较康复前分别降低4.84分和5.73分.体重指数正常COPD患者6 min步行距离改善幅度[由(409.52±98.31)m增加至(433.53±118.46)m]较低体重指数患者改善情况[由(440.07±105.4)m增加至(452.0±110.32)m]更显著;低体重指数患者SGRQ评分较康复前降低9.46分,体重指数正常患者SGRQ评分较康复前降低3.33分.抑郁及焦虑在本研究入选对象中较少见.结论社区呼吸康复可改善COPD患者运动耐力及生活质量,减少急性加重次数.不同严重程度COPD患者均可通过社区呼吸康复干预受益,且患者治疗依从性较高,值得全面推广、应用.
목적 관찰사구호흡강복대만성조새성폐질병(COPD)환자증상급생활질량적영향.방법 선취아원문진급사구COPD환자위연구대상병급여사구호흡강복간예,치료내용포괄건강교육、용약급영양지도、호흡훈련、운동단련등;매4주전화수방1차.우입선시급간예1년후진행료효평정,료효관찰지표포괄폐공능[제일초용력호기용적점예계치백분비(FEV1％)、제일초용력호기용적여용력폐활량비치(FEV1/FVC％)]、골교치호흡문권(SGRQ)、의학연구회호흡곤난량표(MRC)급Borg량표、초필급억욱측평、6 min보행시험(6 MWT)、영양상황등.결과 공유85례환자납입최종통계분석.입선COPD환자강복전FEV1％위(48.11 ±14.54)％,강복후위(47.82± 14.94)％,강복전후차이무통계학의의(P＞0.05);6min보행거리종강복전[(416.10 ±99.84)m]증가지[(437.51±116.17)m],강복전후차이구유통계학의의(P ＜0.05);SGRQ평분교강복전평균강저4.8분;급성가중차수유강복전[(1.07±1.27)차]감지[(0.39±0.69)차](P＜0.01).근거질병엄중도분급,중도급중도이상COPD환자SGRQ평분균교강복전분별강저4.84분화5.73분.체중지수정상COPD환자6 min보행거리개선폭도[유(409.52±98.31)m증가지(433.53±118.46)m]교저체중지수환자개선정황[유(440.07±105.4)m증가지(452.0±110.32)m]경현저;저체중지수환자SGRQ평분교강복전강저9.46분,체중지수정상환자SGRQ평분교강복전강저3.33분.억욱급초필재본연구입선대상중교소견.결론 사구호흡강복가개선COPD환자운동내력급생활질량,감소급성가중차수.불동엄중정도COPD환자균가통과사구호흡강복간예수익,차환자치료의종성교고,치득전면추엄、응용.
Objective To observe the effects of puhnonary rehabilitation on the symptoms and quality of life of persons with chronic obstructive pulmonary disease (COPD).Methods COPD patients were recruited from a hospital and community health centers and given pulmonary rehabilitation in the community.The rehabilitation program included health education and nutrition guidance,medication,breathing exercises,and physical exercise.Each patient was followed up every 4 weeks by telephone.The outcome measures included pulmonary function (FEV1％,FEV1/FVC％),St George's questionnaire (SGRQ),the Medical Research Council scale (MRC),Borg scoring,evaluation of anxiety and depression,the six-minute walk test (6MWT),and an evaluation of nutritional status.All of the patients were observed for one year.Results A total of 85 patients completed the program and were included in the final statistical analysis.There was no difference in FEV1 ％ before and after rehabilitation.Six-minute walking distance improved significantly in statistical terms but the average increase was only from (416.1 ±99.84)m to (437.51 ±116.17)m.The SGRQ scores decreased by an average of 4.8 points after a year of rehabilitation,with significant improvements among the moderately and severely impaired.Incidents of COPD exacerbation also decreased significantly.Patients with a low body mass index had the greatest SGRQ score improvments.Few patients showed depression or anxiety in this research population.Conclusions Pulmonary rehabilitation in the community can improve exercise tolerance and the quality of life for persons with COPD,reducing incidents of acute exacerbation.Patients may benefit from such pulmonary rehabilitation regardless of disease severity.The compliance was good despite the infrequent monitoring.Pulmonary rehabilitation in the community is worthy of more widespread use.