目的 观察肺康复对慢性阻塞性肺疾病(COPD)急性加重期患者的安全性和临床疗效。方法 2015年6月至2016年6月,72例住院COPD急性加重期患者随机分为实验组(n=36)和对照组(n=36)。两组均予抗感染、祛痰、平喘等治疗,并予健康宣教、排痰指导。实验组于入院第3天开始肺康复,直至出院。治疗前后,测量患者的握力、1分钟椅子坐立试验(STST)、住院时间、肺功能、COPD评估测试(CAT)、改良医学研究理事会(mMRC)呼吸困难评分。结果 治疗后,实验组的握力(t=2.985, P<0.01)、STST次数(t=2.024, P<0.05)较对照组增加;CAT评分(t=3.222, P<0.01)、mMRC评分(t=2.212, P<0.05)较对照组下降;实验组的住院时间较对照组有缩短趋势,但无显著性差异(t=1.433, P>0.05);治疗前后,两组肺功能指标无显著性差异(Z<1.031, P>0.05)。结论 COPD急性加重期给予康复锻炼,可提高患者肌力、运动能力,减轻症状。
Objective To investigate the availability and safety of pulmonary rehabilitation for hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Seventy-two hospitalized patients with acute exacerbation of COPD were randomly included into test group (n=36) and control group (n=36) from June, 2015 to June, 2016. All the patients accepted management of anti-infection, phlegm elimination, antiasthma, etc., as well as the guidance of expectoration and health education; while the test group accepted pulmonary rehabilitation from the third day of admission to discharge. Their strength of hand grip, 1-minute sit-to-stand test (STST), the days of hospitalization, lung function parameters, modified Medical Research Council (mMRC) scores and COPD Assessment Test (CAT) scores were measured before and after treatment. Results Compared with the control group, the strength of hand grip (t=2.985, P<0.01) and number of STST (t=2.024, P<0.05) increased, while the scores of CAT (t=3.222, P<0.01) and mMRC (t=2.212, P<0.05) decreased in the test group. The hospital stay seemed to be shorter in the test group than in the control group, but there was no significant difference (t=1.433, P>0.05). There was no significant difference in lung function after treatment in both groups (Z<1.031, P>0.05). Conclusion Pulmonary rehabilitation is effective on hospitalized patients with acute exacerbation of COPD in muscle strength, capability of activities, and relieve the symptoms.
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