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短期肺康复对因慢性阻塞性肺疾病急性加重而住院患者运动能力和生活质量的影响。

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.

作者信息

Ali Mir Shad, Talwar Deepak, Jain S K

出版信息

Indian J Chest Dis Allied Sci. 2014 Jan-Mar;56(1):13-9.

Abstract

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.

摘要

背景

近期研究表明,慢性阻塞性肺疾病急性加重期(AECOPD)患者的肺康复(PR)计划可减轻呼吸困难、提高运动能力并预防进一步加重的发生。

目的

评估为期3周的PR计划对AECOPD患者的效用。

方法

在呼吸重症监护病房(RICU)临床稳定后收治的AECOPD患者,分别交替分配至干预组(n = 15)和对照组(n = 15)。基线评估包括肺活量测定、六分钟步行试验(6MWT)、症状受限的心肺运动试验(CPET)、通过通用问卷医学结局研究简表(S-F 36)问卷进行的健康相关生活质量(HRQoL)评估以及通过Borg评分进行的呼吸困难评估。干预组患者接受常规护理加PR锻炼,形式为步行、自行车测力计运动和阻力运动各20分钟,每周三次,共三周。对照组患者仅接受常规护理。出院后,治疗方案在门诊隔天继续进行,共三周。三周后两组均重复评估。

结果

九次PR锻炼使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CPET上的耗氧量(VO2)/瓦特斜率有统计学意义的改善。

结论

短期PR计划似乎有助于AECOPD的管理。

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