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除 COPD 以外的肺部疾病的康复治疗。

Pulmonary Rehabilitation for Diseases Other Than COPD.

机构信息

Author Affiliations: Division of Pulmonary and Critical Care Medicine, University of Vermont, Burlington, Vermont (Dr Menson); and Respiratory Care Group, Monash University, Melbourne, Victoria, Australia (Dr Dowman).

出版信息

J Cardiopulm Rehabil Prev. 2024 Nov 1;44(6):425-431. doi: 10.1097/HCR.0000000000000915. Epub 2024 Oct 10.

Abstract

Review the current literature regarding pulmonary rehabilitation (PR) for non-chronic obstructive pulmonary disease (COPD) diagnoses and what the evidence is regarding expected outcomes based on disease manifestations. Literature search was performed using PubMed database from March 2024 to June 2024. Terms included "pulmonary rehabilitation" and "exercise training" in conjunction with key words "interstitial lung disease (ILD)," "idiopathic pulmonary fibrosis," "asthma," "bronchiectasis," "post-acute sequalae of SARS-CoV-2 (PASC)," "long COVID," "pulmonary hypertension (PH)," and "lung cancer." Results were filtered for English language, randomized controlled trial, clinical trial, observational trial, meta-analysis, and guidelines. Emphasis was placed on more recent publications since prior reviews, where applicable. The abundance of literature involved ILD, where studies have demonstrated significant improvements in exercise capacity, health-related quality of life (HRQoL), and dyspnea, despite heterogeneity of diseases; benefits are similar to those seen with COPD. Those with milder disease have more sustained benefits longer term. Patients with asthma benefit in severe disease, lower exercise activity, elevated body mass index, or when comorbid conditions are present, and breathing exercises can improve symptoms of breathlessness. Patients with PASC have a multitude of symptoms and lack benefits in HRQoL measurements; PR improves performance on post-COVID-19 functional status scale, a more comprehensive measurement of symptoms. Those with bronchiectasis benefit from PR when airflow limitation or exacerbations are impacting symptoms and HRQoL. Those with stable PH can improve their exertional capacity without change in disease severity. PR reduces perioperative complications in those with lung cancer and preserve fitness during treatment.

摘要

回顾关于非慢性阻塞性肺疾病(COPD)诊断的肺康复(PR)的当前文献,以及根据疾病表现预期结果的证据。使用 PubMed 数据库从 2024 年 3 月至 2024 年 6 月进行文献检索。检索词包括“肺康复”和“运动训练”,并结合“间质性肺疾病(ILD)”、“特发性肺纤维化”、“哮喘”、“支气管扩张”、“SARS-CoV-2 后急性后遗症(PASC)”、“长新冠”、“肺动脉高压(PH)”和“肺癌”等关键词。结果按英语语言、随机对照试验、临床试验、观察性试验、荟萃分析和指南进行过滤。由于适用,强调了最近的出版物。涉及 ILD 的文献丰富,研究表明,尽管疾病存在异质性,但运动能力、健康相关生活质量(HRQoL)和呼吸困难均有显著改善;益处与 COPD 相似。疾病较轻的患者在长期内有更持续的获益。哮喘患者在严重疾病、运动活动减少、体重指数升高或合并症存在时受益,呼吸练习可改善呼吸困难症状。PASC 患者有多种症状,HRQoL 测量结果无获益;PR 改善 COVID-19 后功能状态量表的表现,这是对症状的更全面测量。支气管扩张症患者在气流受限或加重影响症状和 HRQoL 时受益于 PR。稳定 PH 的患者可以在不改变疾病严重程度的情况下改善其运动能力。PR 可减少肺癌患者的围手术期并发症,并在治疗期间保持体能。

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