Donner C F, Fracchia C, Ioli F, Meriggi A, Patessio A, Spada E L, Vecchio C
G Ital Med Lav. 1984 Jan-Mar;6(1-2):51-9.
Epidemiological data show that chronic diseases of the respiratory apparatus have constantly increased over the last 20 years or so, often involving relatively young age classes. The increased survival rates due to chemotherapy also increase the importance of rehabilitation in such diseases. The officially accepted concept of a "global" rehabilitation is particularly significant in the case of patients of working age. The main rehabilitation procedures include chest physiotherapy, aerosol therapy, oxygen therapy (where selection criteria have been established and where there are new prospects related to long-term oxygen therapy), intermittent positive pressure breathing and physical retraining. Details on the methods of assessment and training and data concerning three groups of patients suffering from respectively chronic obstructive lung disease, silicosis and asbestosis, are given. The data show a general pattern of a decrease in ventilation (for an unchanged level of O2 uptake and CO2 output) and reflect a rise in muscular efficiency (exercising and respiratory) enabling the body to perform the same work load at a lower energy cost. The authors discuss the vocational rehabilitation of the patient with lung disease and illustrate the most useful procedures in the assessment of the subject, the environment and the place of work, including guidelines to achieve this. Rehabilitation treatment is also summarized into a number of stages, with the goals at different therapeutic levels and the ways to reach them.
流行病学数据显示，在过去约20年中，呼吸器官的慢性病持续增加，且常常累及相对年轻的年龄段。化疗带来的生存率提高也增加了此类疾病康复治疗的重要性。对于工作年龄段的患者而言，官方认可的“全面”康复理念尤为重要。主要的康复程序包括胸部物理治疗、雾化治疗、氧疗（已确立选择标准且长期氧疗有新前景）、间歇性正压通气和体能再训练。文中给出了分别患有慢性阻塞性肺疾病、矽肺病和石棉沉着病的三组患者的评估方法、训练细节及相关数据。数据显示出通气量下降的总体模式（在氧气摄取量和二氧化碳排出量不变的情况下），并反映出肌肉效率（运动和呼吸方面）的提高，使身体能够以更低的能量消耗完成相同的工作量。作者讨论了肺病患者的职业康复问题，并阐述了在评估患者、环境和工作场所时最有用的程序，包括实现这一目标的指导原则。康复治疗也被总结为若干阶段，以及不同治疗水平的目标和实现这些目标的方法。
