系统化呼吸功能训练在老年慢性阻塞性肺疾病患者康复期中的应用

Application of systematic respiratory function training in the rehabilitation of elderly patients with chronic obstructive pulmonary disease

目的:评估系统化呼吸功能训练在老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者康复期中的应用价值。方法:选取老年COPD患者56例,待病情稳定进入康复期后开展系统化呼吸功能锻炼,包括缩唇呼吸、腹式呼吸、全身呼吸操和人工呼吸阻力训练,同时给予运动指导。观察干预前后患者肺功能指标、呼吸频率、心率的变化,比较干预前后6 min步行试验(6MWT)的距离。结果:干预后,患者第1秒用力呼气量(FEV1)、肺活量(FVC)、第1秒用力呼气量占用力肺活量比(FEV1/FVC)、呼气峰值流速(PEF)和最大呼气中段平均流速(MMEF)等指标均较干预前明显改善,差异有统计学意义(P<0.05或P<0.01);干预后,患者的呼吸频率、心率较干预前明显降低,6MWT距离较干预前明显延长(P<0.05或P<0.01)。结论:对老年COPD康复期患者开展系统化呼吸功能训练有助于改善肺功能,提高运动耐力,延缓病情进展。

Objective: To evaluate the application value of systematic respiratory function training in the rehabilitation of elderly patients with chronic obstructive pulmonary disease(COPD).Methods: A total of 56 elderly patients with COPD were selected and treated with systematic respiratory function training in rehabilitation stage after their disease conditions were stable,including lip girdle respiration,abdominal respiration,systematic respiratory exercise and artificial respiratory resistance training,as well as guidance of movement.The changes of pulmonary function indexes,respiratory frequency and heart rate(HR) were observed before and after interventions,and the distance in 6-min walking test(6 MWT) was compared before and after interventions.Results: After interventions,patients' indexes like forced expiratory volume in first second(FEV1),forced vital capacity(FVC),the ratio of FEV1 in FVC(FEV1/FVC),peak expiratory flow(PEF) and the maximum midexpiratory flow(MMEF) were improved evidently than intervention before,and there were significant differences(P < 0.05 or P < 0.01).After interventions,patients' respiratory frequency and HR decreased notably while 6 MWT increased prominently than before(P < 0.05 or P < 0.01).Conclusion: Conduction of systematic respiratory function training can improve the pulmonary function,increase exercise tolerance and postpone disease progression in elderly patients with COPD in rehabilitation stage.