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目的探讨多学科综合呼吸康复对老年中、重度COPD患者的康复效果。方法 88例稳定期老年COPD患者随机分为康复组50例和对照组38例,康复组除常规内科药物治疗外均进行12周的多学科综合呼吸康复,对照组只采用常规内科药物治疗。2组患者治疗前及12周时均进行心肺运动试验、BODE指数评分及生存质量评分。结果康复组治疗后的Wmax、VO2max、6-MWD、MMRC、BODE指数、日常生活能力、社会活动情况、抑郁及焦虑心理症状均较康复前有显著改善,差异有统计学意义(P<0.01),以上指标和对照组治疗后对比,差异也具有统计学意义(P<0.05或0.01)。对照组的Wmax、VO2max、BODE指数各项指标以及生存质量各项目评分前、后对比差异均无统计学意义(P>0.05)。结论多学科综合呼吸康复能显著提高老年中、重度COPD稳定期患者的康复效果,改善运动耐量及生存质量,运动训练是综合呼吸康复因素的核心。
Objective To explore the rehabilitation effect of multidisciplinary comprehensive respiratory rehabilitation on elderly patients with moderate and severe COPD. Methods A total of 88 elderly stable COPD patients were randomly divided into rehabilitation group (n = 50) and control group (n = 38). All patients in rehabilitation group underwent 12-week multi-disciplinary comprehensive respiratory rehabilitation except conventional medical treatment. The control group received conventional medical treatment only. Cardiac exercise tests, BODE index and quality of life scores were performed in both groups before and 12 weeks after treatment. Results Wmax, VO2max, 6-MWD, MMRC, BODE index, daily living ability, social activities, depression and anxiety psychological symptoms in rehabilitation group were significantly improved after rehabilitation compared with those before rehabilitation (P <0.01) The difference between the above indexes and the control group after treatment was also statistically significant (P <0.05 or 0.01). The control group Wmax, VO2max, BODE index of various indicators and quality of life of the project before and after the score was no significant difference (P> 0.05). Conclusions Multidisciplinary comprehensive respiratory rehabilitation can significantly improve the rehabilitation effect and improve the exercise tolerance and quality of life in elderly patients with moderate and severe COPD. Exercise training is the core of comprehensive respiratory rehabilitation.