Won Yu Hui, Cho Yoon Soo, Joo So Young, Seo Cheong Hoon
Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907 Korea.
Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, 94-200 Yeongdeungpo-Dong Yeongdeungpo-Ku, Seoul 07247, Korea.
J Clin Med. 2020 Jul 15;9(7):2250. doi: 10.3390/jcm9072250.
We performed pulmonary function (PF) tests and factors affecting PF evaluation in 120 patients with inhalation injury to evaluate the effects of pulmonary rehabilitation (PR) in burn patients with inhalation injury. Patients were randomized into pulmonary rehabilitation (PR) group and conventional rehabilitation (CON) group. PF tests, including forced vital capacity (FVC), 1-s forced expiratory volume FEV1), maximum voluntary ventilation (MVV), and respiratory muscles strength (maximal expiratory pressure (MEP) and maximal inspiratory pressure (MIP)), were measured by mouth pressure meter in the sitting position. Diffusing capacity for carbon monoxide (DLco) was determined by the single-breath carbon monoxide technique. Peak cough flow (PCF) was measured by a peak flow meter. Diaphragmatic mobility (DM) was evaluated on anteroposterior fluoroscopy. All evaluations were performed in all groups at baseline and after 12 weeks. There were no differences in evaluations between the PR group and CON group before the intervention. There were significant improvements in the PCF and MIP (%) changes, taken before and after rehabilitation in the PR group, compared with the changes in the CON group ( = 0.01, and = 0.04). There were no significant changes in the other parameters in the PR group compared with the changes in the CON group ( > 0.05). There were significant differences in DLco (%), MIP, MIP (%), and DM between the PR group and the CON group ( = 0.02, = 0.005, and = 0.001) after 12 weeks of rehabilitation. There were no differences between the PR group and CON group after 12 weeks rehabilitation in the other parameters ( > 0.05). PR for patients with major burns and smoke inhalation induced improved PCF, MIP, MIP (%), DLco (%), and DM. These results show that PR should be a fundamental component of the treatment program for patients with burns.
我们对120例吸入性损伤患者进行了肺功能（PF）测试及影响PF评估的因素分析，以评估肺康复（PR）对烧伤合并吸入性损伤患者的效果。患者被随机分为肺康复（PR）组和传统康复（CON）组。采用口腔压力计在坐位测量PF测试指标，包括用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、最大自主通气量（MVV）以及呼吸肌力量（最大呼气压力（MEP）和最大吸气压力（MIP））。采用单次呼吸一氧化碳技术测定一氧化碳弥散量（DLco）。用峰值流量计测量峰值咳嗽流量（PCF）。通过前后位荧光透视评估膈肌活动度（DM）。所有评估在所有组的基线及12周后进行。干预前PR组和CON组的评估无差异。与CON组相比，PR组康复前后PCF和MIP（%）变化有显著改善（ = 0.01， = 0.04）。与CON组相比，PR组其他参数无显著变化（ > 0.05）。康复12周后，PR组和CON组在DLco（%）、MIP、MIP（%）和DM方面存在显著差异（ = 0.02， = 0.005， = 0.001）。康复12周后，PR组和CON组在其他参数方面无差异（ > 0.05）。对重度烧伤合并烟雾吸入患者进行PR可改善PCF、MIP、MIP（%）、DLco（%）和DM。这些结果表明，PR应成为烧伤患者治疗方案的基本组成部分。
