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住院期间肺康复对不同慢性呼吸系统疾病患者的影响。

Impact of pulmonary rehabilitation on patients with different chronic respiratory diseases during hospitalization.

机构信息

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

出版信息

Medicine (Baltimore). 2024 Apr 12;103(15):e37778. doi: 10.1097/MD.0000000000037778.

Abstract

The impact of pulmonary rehabilitation (PR) on patients with different chronic respiratory diseases (CRDs) during hospitalization has not been thoroughly evaluated before. The objectives of the current research were to assess the effect of comprehensive PR management on inpatients' self-management skills, exercise capacity, nutrition assessment and mental health issues and explore whether impacts of PR vary in different CRDs. This retrospective study analyzed the clinical data from 272 inpatients with CRDs receiving PR management during hospitalization between October 2020 and March 2022 in Beijing Chao-Yang Hospital. Significant improvements were found in the patients' ability of daily living (ADL), dyspnea (assessed by modified medical research council dyspnea scale (MMRC)), handgrip strength, maximal inspiratory and expiratory pressure, anxiety (using the 7-item generalized anxiety disorder scale (GAD-7)) and depression (the 9-item patient health questionnaire score (PHQ-9)). There was no significant change in nutrition assessment pre-post PR management during hospitalization. The subgroup analyses were conducted on hospitalized patients with chronic obstructive pulmonary disease (COPD), bronchiectasis, asthma, interstitial lung diseases (ILDs) and other CRDs (e.g., lung cancer, diaphragm hemiparesis, obesity, etc.). The results showed that ADL, MMRC score, MIP, MEP, PHQ-9 score improved in all subgroups with CRDs. Handgrip strength of left hand was increased in COPD inpatients and anxiety was improved in all subgroups except for ILDs. Comprehensive PR management was necessary and beneficial for patients with different CRDs during hospitalization.

摘要

在住院期间,肺康复(PR)对不同慢性呼吸系统疾病(CRD)患者的影响尚未得到彻底评估。本研究的目的是评估综合 PR 管理对住院患者自我管理技能、运动能力、营养评估和心理健康问题的影响,并探讨 PR 的影响是否因不同的 CRD 而有所不同。这项回顾性研究分析了 2020 年 10 月至 2022 年 3 月期间在北京朝阳医院接受住院 PR 管理的 272 例 CRD 住院患者的临床数据。患者的日常生活能力(ADL)、呼吸困难(采用改良医学研究委员会呼吸困难量表(MMRC)评估)、握力、最大吸气和呼气压力、焦虑(使用 7 项广泛性焦虑障碍量表(GAD-7))和抑郁(9 项患者健康问卷评分(PHQ-9))均有显著改善。住院期间 PR 管理前后营养评估无显著变化。对住院的慢性阻塞性肺疾病(COPD)、支气管扩张症、哮喘、间质性肺疾病(ILDs)和其他 CRD(如肺癌、膈肌偏瘫、肥胖症等)患者进行了亚组分析。结果显示,所有 CRD 亚组的 ADL、MMRC 评分、MIP、MEP、PHQ-9 评分均有所改善。COPD 住院患者左手握力增加,除 ILD 外,所有亚组的焦虑均有所改善。综合 PR 管理对住院期间不同 CRD 患者是必要且有益的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5822/11018183/e1b605a6cf3b/medi-103-e37778-g001.jpg

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