早期肺康复治疗对急性加重期COPD患者远期生存质量的影响

Influence of early pulmonary rehabilitation therapy on long- term life quality of COPD patients in acute exacerbation

目的：探讨早期肺康复治疗对急性加重期COPD（AECOPD）患者远期生存质量的影响。方法：将2014年1—8月我院呼吸内科重症监护病房收治的AECOPD患者80例随机分为肺康复组42例和对照组38例，对照组给予常规治疗；肺康复组在常规治疗基础上接受为期6周的早期肺康复治疗。测量两组患者的肺功能、6mm步行测试，同时评估患者体力活动情况、呼吸困难程度、焦虑抑郁情绪、生活质量，治疗6个月后随访全部患者并进行再评估。结果：治疗6个月后随访两组患者6min步行测试、体力活动活跃程度均高于基线，而改良mMRC呼吸困难指数得分、焦虑及抑郁得分以及COPD评估问卷得分均较基线降低（P〈0．05）。肺康复组患者6min步行测试距离、体力活动活跃程度均高于对照组（P〈0．05），而改良mMRC呼吸困难指数、焦虑、抑郁以及COPD评估问卷得分均低于对照组患者（P〈0．05）。结论：COPD患者早期肺康复治疗可以提高患者体力活动水平，降低焦虑、抑郁情绪，提高患者的生存质量。

Objective ： To explore the influence of early pulmonary rehabilitation therapy on long - term life quality of COPD patients in acute exacerbation （AECOPD）. Methods：Bandomly divided 80 AECOPD patients admitted in intensive care unit of respiratory medicine in our hospital from January 2014 to August 2014 into pulmonary rehabilitation group with 42 cases and control group with 38 cases. The control group was given with routine therapy; the pul- monary rehabilitation group received 6 - week early pulmonary rehabilitation therapy on the basis of routine therapy. Measured pulmonary function of patients in the two groups and conducted 6 - minute walk test. Meanwhile, assess patients＇ physical activity condition, dyspnea level, emotion of anxiety and depression and life quality. After 6 - month treatment, conducted follow - up visit and reassessment on all patients. Results： In follow - up visit after the 6 - month treatment, the 6 - minute walk test and physical activity level of patients in the two groups were all higher than the baseline, while modified mMRC dyspnea index score, anxiety and depression scores and COPD assessment questionnaire score all declined, compared with the baseline （P 〈 0.05 ）. The 6 - minute walk test distance and physical activity level of patients in the pulmonary rehabilitation group were all higher than those of the control group （ P 〈 0.05 ）, while modified mMRC dyspnea index, anxiety, depression and COPD assessment questionnaire scores were all lower than those of patients in the control group （P 〈 0.05 ）. Conclusion： Early pulmonary rehabilitation therapy of COPD patients can improve patients＇physical activity level, reduce emotion of anxiety and depression, and enhance patients＇life quality.