Providence (R.I.) Veterans Affairs Medical Center, Providence, Rhode Island, USA.
Am Fam Physician. 2010 Sep 15;82(6):655-60.
Pulmonary rehabilitation is a nonpharmacologic therapy that has emerged as a standard of care for patients with chronic obstructive pulmonary disease. It is a comprehensive, multidisciplinary, patient-centered intervention that includes patient assessment, exercise training, self-management education, and psychosocial support. In the United States, pulmonary rehabilitation is usually given in outpatient, hospital-based programs lasting six to 12 weeks. Positive outcomes from pulmonary rehabilitation include increased exercise tolerance, reduced dyspnea and anxiety, increased self-efficacy, and improvement in health-related quality of life. Hospital admissions after exacerbations of chronic obstructive pulmonary disease are also reduced with this intervention. The positive outcomes associated with pulmonary rehabilitation are realized without demonstrable improvements in lung function. This paradox is explained by the fact that pulmonary rehabilitation identifies and treats the systemic effects of the disease. This intervention should be considered in patients who remain symptomatic or have decreased functional status despite optimal medical management. Medicare now covers up to 36 sessions of pulmonary rehabilitation in patients with moderate, severe, and very severe chronic obstructive pulmonary disease.
肺康复是一种非药物治疗方法，已成为慢性阻塞性肺疾病患者的标准治疗方法。它是一种全面的、多学科的、以患者为中心的干预措施，包括患者评估、运动训练、自我管理教育和社会心理支持。在美国，肺康复通常在门诊、医院为基础的方案中进行，持续 6 至 12 周。肺康复的积极结果包括增加运动耐量、减少呼吸困难和焦虑、增加自我效能和改善健康相关生活质量。这种干预也减少了慢性阻塞性肺疾病加重后的住院率。与肺康复相关的积极结果是在没有明显改善肺功能的情况下实现的。这种矛盾现象可以通过肺康复识别和治疗疾病的全身影响来解释。对于即使经过最佳药物治疗仍有症状或功能状态下降的患者，应考虑进行这种干预。医疗保险现在涵盖了中度、重度和非常重度慢性阻塞性肺疾病患者多达 36 次的肺康复治疗。
