Grosbois J M, Douay B, Fortin F, Dernis J M, Lemaire B, Boutemy J, Gosset P, Plez R, Van-Hecke A, Vanpoulle C
CLEFAR Réhabilitation Respiratoire, Clinique de la Louvière, Lille.
Rev Mal Respir. 1996;13(1):61-7.
Respiratory rehabilitation is a multidisciplinary medical approach which allows a total care of patients suffering from COPD. Optimisation of bronchodilator treatment, health education, cessation of smoking, dietetic, relaxation and re-entrainment to effort. We report out experience concerning 88 BPCO (mean age 62.1, FEV1 of 1.4 litres; or 48% of predicted normal); these 88 patients were cared for on an ambulatory basis at our centre for two hours per session, three times per week for seven weeks. The objective results were analysed on exercise tests before and after treatment. For ventilation, there was a significant improvement in the power developed (from 45.5+/-17.1 to 53.4+/-23 watts; p<0.001) without any change in the oxygen consumption (VO2), ventilation (VE) or heart rate (FC) and of oxygen pulse (VO2/FC). For the same level of power (80% of maximum power for the initial exercise test) there was a significant lowering of ventilation (V=33.5+/-9.4 to 30.7+/-7.4 litres per minute, p<0.001), cardiac frequency (FC: from 116.9+/-16 to 111.1+/-13.1 beats per minute, p<0.001) as well as the oxygen pulse (VO2/FC: from 7.9+/-2.7 to 8.3+/-3.7). At the maximum on the exercise test all the parameters studied were significantly better: watts, VO2, VE, cardiac frequency and VO2/FC. A study of the visual analogue scale (EVA), analysing sleep, anxiety, dyspnoea and the physical aspects showed a significant improvement in the four subjective parameters. Respiratory rehabilitation of BPCO practiced as an out patient has shown an improvement in exercise tolerance in every day activities and improvement in dyspnoea and in the quality of life.
呼吸康复是一种多学科的医学方法，可对慢性阻塞性肺疾病（COPD）患者进行全面护理。包括优化支气管扩张剂治疗、健康教育、戒烟、饮食、放松以及恢复运动能力。我们报告了关于88例慢性阻塞性肺疾病患者（平均年龄62.1岁，第一秒用力呼气容积为1.4升，占预计正常值的48%）的经验；这88例患者在我们中心接受门诊治疗，每次治疗两小时，每周三次，共七周。在治疗前后的运动测试中分析客观结果。对于通气功能，所产生的功率有显著改善（从45.5±17.1瓦提高到53.4±23瓦；p<0.001），而耗氧量（VO2）、通气量（VE）、心率（FC）和氧脉搏（VO2/FC）均无变化。对于相同功率水平（初始运动测试最大功率的80%），通气量（从33.5±9.4升/分钟降至30.7±7.4升/分钟，p<0.001）、心率（从116.9±16次/分钟降至111.1±13.1次/分钟，p<0.001）以及氧脉搏（从7.9±2.7降至8.3±3.7）均有显著降低。在运动测试达到最大值时，所有研究参数均显著改善：功率、VO2、VE、心率和VO2/FC。对视觉模拟量表（EVA）进行研究，分析睡眠、焦虑症、呼吸困难和身体状况，结果显示四个主观参数均有显著改善。作为门诊治疗进行的慢性阻塞性肺疾病呼吸康复已显示出日常活动中的运动耐力有所提高，呼吸困难和生活质量也有所改善。
