肺康复训练在肺移植术后受者康复过程中的疗效观察

Observational study of the effect of pulmonary rehabilitation in the rehabilitation process of recipients after lung transplantation

目的探讨肺康复训练在肺移植术后受者康复过程中的疗效观察。方法选取2016年8月至2019年5月期间在河南省人民医院进行肺移植手术的25例患者,按照手术实施先后顺序编号随机分为实验组和对照组,3例患者因病情变化退出,最终纳入实验组(n=12)和对照组(n=10),给予对照组简单呼吸训练,实验组肺康复训练。分别于训练前、训练后(出院时)测定两组患者肺功能,膈肌厚度分数(DTF),呼吸困难程度,运动能力及出院后3个月、6个月采用圣乔治呼吸问卷评价两组患者生活质量。结果训练后(出院时)实验组第1秒用力呼气量占预计值百分比、第1秒用力呼气量/用力肺活量及DTF均较治疗前和对照组显著改善(P<0.05)。出院后3个月时,实验组与对照组生活质量无明显差异;6个月时,实验组患者呼吸症状及疾病影响较干预3个月时有明显改善。结论肺康复训练有助于改善肺移植术后患者肺功能、膈肌功能,提高运动能力,院外康复期患者生活质量。

Objective To investigate the effect of pulmonary rehabilitation on the rehabilitation process of recipients after lung transplantation.Methods Twenty-five patients who underwent lung transplantation in Henan Provincial People′s Hospital from August 2016 to May 2019 were randomly divided into the experimental group and the control group according to the sequence of the operation.3 patients withdrew due to changes in their condition.Finally,the experimental group(n=12)and the control group(n=10)were included.The control group was given simple breathing training,and the experimental group was given pulmonary rehabilitation training.Lung function,diaphragmatic thickness score(DTF),dyspnea score,and exercise capacity were evaluated before and after training(discharge),and the St.George′s respiratory questionnaire was also performed to evaluate the quality of life of the two groups of patients,at 3 months and 6 months post-discharge.Results After the in-hospital treatment,the percentage of forced expiratory volume in 1 second to predicted value,the forced expiratory volume in 1 second/forced vital capacity,and the DTF were significantly improved compared with those before treatment and the control group(P<0.05).At 3 months post-discharge,there was no significant difference in the quality of life between the experimental group and the control group;At 6 months post-discharge,the respiratory symptoms and disease involvement of patients in the experimental group were significantly improved compared to 3 months post-discharge.Conclusion Pulmonary rehabilitation training can help to improve lung function,diaphragm function,exercise capacity,and the quality of life in patients in the out-of-hospital rehabilitation period after lung transplantation.