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[肺结核后遗症患者的功能评估]

[Functional evaluation in patients with pulmonary tuberculosis sequelae].

作者信息

Di Naso F C, Pereira J S, Schuh S J, Unis G

机构信息

Serviço de Fisioterapia, Hospital Sanatório Partenon, Porto Alegre (RS), Brasil.

出版信息

Rev Port Pneumol. 2011 Sep-Oct;17(5):216-21. doi: 10.1016/j.rppneu.2011.06.010. Epub 2011 Jul 30.

Abstract

INTRODUCTION

In pulmonary tuberculosis, the presence of extensive residual lung lesions can be a predictor of permanent disability due to respiratory failure.

OBJECTIVE

To compare functional and respiratory changes in patients with pulmonary tuberculosis sequel who have completed treatment.

METHOD

The study included patients who completed treatment within a period of 6 months (group I) and multidrug-resistant pulmonary tuberculosis patients who completed treatments of longer duration after the failure of the initial treatment (group II). We evaluated lung function by spirometry (Microlab ML 3500), the strength of respiratory muscles through the manovacuometry (MEP-maximal expiratory pressure and MIP- maximal inspiratory pressure) and the distance walked during the 6-minute walk (6MWT).

RESULTS

27 patients were included, 12 of whom belonged to group II, multidrug-resistant tuberculosis (MDRTB). Severe combined respiratory disorder was the most prevalent problem in group II of MDRTB; it was present in 9 patients. The MDRTB group (group II) showed significantly lower values when compared to Group I in FVC (72.06±14.95 vs 43.58±16.03% predicted), FEV1 (66.13±19.87 vs 33.08±15.64% predicted), MIP (68.40±22.78 vs 49.58±12.55 cmH(2)O), MEP (87.20±27.30 vs 59.08±12.23 cmH(2)O) and distance covered in 6MWT (484.21±74.01 vs 334.75±104.07 meters).

CONCLUSION

Patients with multidrug resistant pulmonary tuberculosis who have undergone multiple treatments have more severe respiratory and functional impairment than patients who have had just a single treatment.

摘要

引言

在肺结核中,广泛的残留肺部病变的存在可能是呼吸衰竭导致永久性残疾的一个预测指标。

目的

比较已完成治疗的肺结核后遗症患者的功能和呼吸变化。

方法

该研究纳入了在6个月内完成治疗的患者(第一组)以及初始治疗失败后完成更长疗程治疗的耐多药肺结核患者(第二组)。我们通过肺活量测定法(Microlab ML 3500)评估肺功能,通过压力计测量呼吸肌力量(MEP-最大呼气压力和MIP-最大吸气压力)以及6分钟步行试验(6MWT)中的步行距离。

结果

共纳入27例患者,其中12例属于第二组,即耐多药结核病(MDRTB)。严重的联合呼吸障碍是耐多药结核病第二组中最普遍的问题;9例患者存在该问题。与第一组相比,耐多药结核病组(第二组)在用力肺活量(FVC)(预计值的72.06±14.95% vs 43.58±16.03%)、第一秒用力呼气容积(FEV1)(预计值的66.13±19.87% vs 33.08±15.64%)、最大吸气压力(MIP)(68.40±22.78 vs 49.58±12.55 cmH₂O)、最大呼气压力(MEP)(87.20±27.30 vs 59.08±12.23 cmH₂O)以及6MWT中的步行距离(484.21±74.01 vs 334.75±104.07米)方面的数值显著更低。

结论

接受多次治疗的耐多药肺结核患者比仅接受一次治疗的患者存在更严重的呼吸和功能损害。

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