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新冠肺炎患者的肺康复:当前实践及其在疫情期间应用的范围综述

Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic.

作者信息

Siddiq Md Abu Bakar, Rathore Farooq Azam, Clegg Danny, Rasker Johannes J

机构信息

Department of Physical Medicine and Rehabilitation, Brahmanbaria Medical College, Brahmanbaria, Bangladesh.

School of Health Sports and Professional Practice, University of South Wales, Pontypridd, United Kingdom.

出版信息

Turk J Phys Med Rehabil. 2020 Nov 9;66(4):480-494. doi: 10.5606/tftrd.2020.6889. eCollection 2020 Dec.

Abstract

The novel coronavirus-2019 (COVID-19) pandemic primarily affects the respiratory system. Elderly individuals with comorbidity are severely affected. Survivors weaned from mechanical ventilation are at a higher risk of developing post-intensive care syndrome (PICS). This scoping review, based on 40 recent publications, highlights pulmonary rehabilitation (PR) in COVID-19. There is a paucity of high-quality research on this topic. However, rehabilitation societies including the Turkish Society of Physical Medicine and Rehabilitation have issued PR recommendations in COVID-19 pneumonia with productive cough can benefit from diaphragmatic breathing, pursed-lip breathing, and resistance-breathing training. Besides, those in mechanical ventilation and post-PICS COVID-19 cases, oxygen therapy, early mobilization, airway clearance, aerobic exercise, gradual-graded limb muscle resistance exercise, nutritional and psychological interventions should be consideration. During PR, careful evaluation of vital signs and exercise-induced symptoms is also required. When in-person PR is not possible, telerehabilitation should be explored. However, the long-term effects of PR in COVID-19 need further evaluation.

摘要

2019年新型冠状病毒(COVID-19)大流行主要影响呼吸系统。患有合并症的老年人受影响严重。从机械通气中撤机的幸存者发生重症监护后综合征(PICS)的风险更高。这项基于最近40篇出版物的范围综述重点介绍了COVID-19中的肺康复(PR)。关于这一主题的高质量研究很少。然而,包括土耳其物理医学与康复学会在内的康复协会已发布了COVID-19肺炎的PR建议,有咳痰的患者可从膈肌呼吸、缩唇呼吸和阻力呼吸训练中受益。此外,对于机械通气患者以及COVID-19后PICS患者,应考虑进行氧疗、早期活动、气道清理、有氧运动、渐进性肢体肌肉抗阻运动、营养和心理干预。在进行PR期间,还需要仔细评估生命体征和运动诱发症状。当无法进行面对面PR时,应探索远程康复。然而,PR对COVID-19的长期影响需要进一步评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e52/7756838/0230d8545978/TJPMR-2020-66-4-480-494-F1.jpg

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