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严重流感 A(H1N1)性肺炎所致急性呼吸窘迫综合征幸存者经肺康复后肺功能、运动能力和生活质量的恢复。

Recovery of pulmonary functions, exercise capacity, and quality of life after pulmonary rehabilitation in survivors of ARDS due to severe influenza A (H1N1) pneumonitis.

机构信息

Department of Pulmonary and Critical Care Medicine, Chia-Yi Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chiayi, Taiwan.

Department of Respiratory Therapy, School of Medicine, Chang-Gung University, Taoyuan, Taiwan.

出版信息

Influenza Other Respir Viruses. 2018 Sep;12(5):643-648. doi: 10.1111/irv.12566. Epub 2018 Jun 12.

Abstract

BACKGROUND

Acute respiratory distress syndrome (ARDS) due to severe influenza A H1N1 pneumonitis would result in impaired pulmonary functions and health-related quality of life (HRQoL) after hospital discharge.

OBJECTIVES

The recovery of pulmonary functions, exercise capacity, and HRQoL in the survivors of ARDS due to 2009 pandemic influenza A H1N1 pneumonitis (H1N1-ARDS) was evaluated in a tertiary teaching hospital in northern Taiwan between May 2010 and June 2011.

PATIENTS AND METHODS

Data of spirometry, total lung capacity (TLC), diffusing capacity of carbon monoxide (DL ), and 6-minute walk distance (6MWD) in the patients survived from H1N1-ARDS were collected 1, 3, and 6 months post-hospital discharge. HRQoL was evaluated with St. George respiratory questionnaire (SGRQ).

RESULTS

Nine survivors of H1N1-ARDS in the study period were included. All these patients received 2 months' pulmonary rehabilitation program. Pulmonary functions and exercise capacity included TLC, forced vital capacity (FVC), forced expiratory volume in the first second (FEV ), DL , and 6MWD improved from 1 to 3 months post-hospital discharge. Only TLC had further significant improvement from 3 to 6 months. HRQoL represented as the total score of SGRQ had no significant improvement in the first 3 months but improved significantly from 3 to 6 months post-discharge.

CONCLUSION

The impaired pulmonary functions and exercise capacity in the survivors of H1N1-ARDS improved soon at 3 months after hospital discharge. Their quality of life had keeping improved at 6 months even though there was no further improvement of their pulmonary functions and exercise capacity.

摘要

背景

由严重甲型 H1N1 流感引起的急性呼吸窘迫综合征(ARDS)会导致肺部功能受损和健康相关生活质量(HRQoL)下降,在出院后仍会持续存在。

目的

本研究旨在评估台湾北部某教学医院在 2010 年 5 月至 2011 年 6 月期间收治的 2009 年甲型 H1N1 流感相关 ARDS(H1N1-ARDS)幸存者出院后肺部功能、运动能力和 HRQoL 的恢复情况。

患者和方法

本研究收集了幸存者出院后 1、3 和 6 个月的肺量计、肺总量(TLC)、一氧化碳弥散量(DL )和 6 分钟步行距离(6MWD)等数据。采用圣乔治呼吸问卷(SGRQ)评估 HRQoL。

结果

研究期间共纳入 9 例 H1N1-ARDS 幸存者,所有患者均接受了 2 个月的肺康复计划。出院后 1 至 3 个月,TLC、用力肺活量(FVC)、第 1 秒用力呼气量(FEV )、DL 和 6MWD 等肺部功能和运动能力逐渐改善,其中仅 TLC 在出院后 3 至 6 个月时进一步显著改善。SGRQ 总评分代表 HRQoL,在出院后 3 个月内无明显改善,但在出院后 3 至 6 个月时显著改善。

结论

H1N1-ARDS 幸存者出院后 3 个月时受损的肺部功能和运动能力迅速改善,尽管肺部功能和运动能力没有进一步改善,但出院后 6 个月时生活质量仍持续提高。

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