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慢性阻塞性肺疾病患者在接受肺康复治疗后的疼痛。

Pain in patients with chronic obstructive pulmonary disease indicated for post-acute pulmonary rehabilitation.

机构信息

1 Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands.

2 Zorggroep Solis, Deventer, The Netherlands.

出版信息

Chron Respir Dis. 2019 Jan-Dec;16:1479972318809456. doi: 10.1177/1479972318809456.

Abstract

Pain is a significant problem in stable chronic obstructive pulmonary disease (COPD) and is associated with other symptoms, worse health status and lower functional status. Not much is known about pain in unstable disease. The primary aim of the present study is to investigate prevalence, characteristics and relationships of pain in patients with COPD hospitalized for an acute exacerbation (AECOPD) and indicated for post-acute pulmonary rehabilitation (PR). This cross-sectional observational study included 149 patients (mean age 70.8 (±7.9) years, 49% male, mean forced expiratory volume in one second as percentage of predicted value 35.3 (±12.6)). Pain was assessed using the brief pain inventory. Functional status and health status were measured using the six-minute walking test (6MWT), the Barthel index (BI) and the clinical COPD questionnaire (CCQ), respectively. Pain was prevalent in 39.6% of all patients. Symptom burden was high, especially in patients with pain. Although we found no difference in objective measurements of functional status (6MWT, BI), patients with pain had clinically relevant lower health status (CCQ), attributed to the functional domain. Pain in patients hospitalized for AECOPD and indicated for post-acute PR is a relevant problem and needs more attention. Incorporation of standard pain assessment during exacerbations and post-acute PR is recommended.

摘要

疼痛是稳定期慢性阻塞性肺疾病(COPD)的一个严重问题,与其他症状、更差的健康状况和更低的功能状态有关。对于不稳定疾病中的疼痛,我们知之甚少。本研究的主要目的是调查因急性加重(AECOPD)住院并适合进行急性后肺康复(PR)的 COPD 患者中疼痛的患病率、特征和相关性。这项横断面观察性研究纳入了 149 名患者(平均年龄 70.8(±7.9)岁,49%为男性,预计值第一秒用力呼气量占比 35.3(±12.6)%)。使用简短疼痛量表评估疼痛。使用六分钟步行试验(6MWT)、巴氏指数(BI)和临床 COPD 问卷(CCQ)分别测量功能状态和健康状况。所有患者中疼痛的患病率为 39.6%。症状负担较高,尤其是疼痛患者。尽管我们在功能状态的客观测量(6MWT、BI)方面没有发现差异,但有疼痛的患者的健康状况(CCQ)具有临床相关的较低水平,这归因于功能领域。因 AECOPD 住院且适合进行急性后 PR 的患者的疼痛是一个相关问题,需要更多关注。建议在加重期和急性后 PR 期间纳入标准疼痛评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e5e/6301839/fe872410b1fd/10.1177_1479972318809456-fig1.jpg

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