Kanamori K, Okubo K
Division of Pulmonary Disease, Fukui Cardiovascular Center, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Apr;34(4):397-403.
To evaluate the effects of pulmonary rehabilitation in patients with chronic respiratory failure, 43 patients with stable chronic respiratory failure were enrolled in a pulmonary rehabilitation program. The program included education, instruction in diaphragmatic breathing, respiratory muscle training, and exercise training (walking and riding a stationary bicycle). Patients were divided into 2 groups by the lowest SpO2 during a 12-minute-walk test done before rehabilitation: lowest SpO2 < 90% (Group A, 32 patients) and lowest SpO2 > or = 90% (Group B, 11 patients). In group A, SpO2 during exercise training was maintained over 90% by O2 inhalation, by load reduction, or by maintaining a slower walking speed. During 2 months of rehabilitation, the distance walked in 12 minutes and the maximum distance walked with an SpO2 > or = 90% significantly increased in both groups, but PaO2, VC, and FEV1 increased only in group A. In group A, the patients with chronic obstructive pulmonary disease had significant increases in PaO2, VC, and FEV1, but those with old tuberculosis sequelae had significant increases in PaO2 only. Pulmonary rehabilitation in patients with chronic respiratory failure may not only increase exercise tolerance but may also improve arterial oxygenation and pulmonary function.
为评估肺康复对慢性呼吸衰竭患者的影响,43例稳定期慢性呼吸衰竭患者纳入肺康复计划。该计划包括教育、膈肌呼吸指导、呼吸肌训练和运动训练(步行和骑固定自行车)。根据康复前12分钟步行试验期间的最低SpO₂将患者分为2组:最低SpO₂<90%(A组,32例患者)和最低SpO₂≥90%(B组,11例患者)。在A组中,通过吸氧、减轻负荷或保持较慢步行速度,运动训练期间的SpO₂维持在90%以上。在2个月的康复期间,两组患者12分钟内行走的距离以及SpO₂≥90%时行走的最大距离均显著增加,但仅A组的动脉血氧分压(PaO₂)、肺活量(VC)和第一秒用力呼气容积(FEV₁)增加。在A组中,慢性阻塞性肺疾病患者的PaO₂、VC和FEV₁显著增加,但陈旧性肺结核后遗症患者仅PaO₂显著增加。慢性呼吸衰竭患者的肺康复不仅可以提高运动耐力,还可能改善动脉氧合和肺功能。