肺移植术后早期量化肺康复治疗对患者肺功能的影响

Effects of Early Quantitative Pulmonary Rehabilitation Therapy on Patients'Lung Function After Lung Transplantation

目的探讨量化肺康复治疗对肺移植术后早期患者肺功能的影响。方法选取我院2019年1月至2020年6月肺移植术后患者30例,随机分为试验组和对照组各15例。所有患者术后常规接受我院肺移植中心临床干预治疗,对照组由物理治疗师进行常规肺康复治疗,包括抗阻训练、呼吸肌训练、气道廓清能力训练,30 min/次,1次/d;试验组在对照组的基础上接受物理治疗师量化肺康复,30 min/次,1次/d,治疗5 d/周,共介入3周。两组患者于肺移植术前和康复治疗3周后分别采用肺功能仪评估1秒用力呼气量占预计值比(FEV1%)、用力肺活量占预计值比(FVC%)、1秒用力呼气量/用力肺活量(FEV1/FVC)、最大吸气压(MIP);采用六分钟步行距离(6MWD)和De Morton活动指数(DEMMI)测定两组患者的运动功能改善情况,并对两组患者治疗前后炎症指标、住院时间进行分析。结果治疗3周后,两组患者FEV1%、FVC%、FEV1/FVC、6MWD和DEMMI较治疗前均有显著提高(P<0.05),且试验组显著优于对照组(P<0.05);两组患者外周血WBC计数、PCT、CRP较治疗前均降低(P<0.05),且试验组显著优于对照组(P<0.05);试验组住院时间较对照组明显缩短(P<0.05)。结论肺移植术后早期量化肺康复治疗更有利于提高患者心肺功能,改善炎症指标,缩短住院周期,值得临床推广。

Objective To study effects of early quantitative pulmonary rehabilitation therapy on patients'lung function after lung transplantation.Methods From January 2019 to June 2020,30 patients after lung transplantation in our hospital were selected and divided into experimental group(EG)and control group(CG)using a random number table method,with 15 cases in each group.All patients received routine interventions from lung transplant center of our hospital after operation.CG received routine pulmonary rehabilitation treatment by physical therapists,including resistance training,respiratory muscle training,and airway clearance training,30 min/time,1 time/d.On the basis of CG,EG received physiotherapist quantitative pulmonary rehabilitation,30 min/time,1 time/d.Patients were treated with pulmonary rehabilitation for 5 days/week for a total of 3 weeks.Before lung transplantation and 3 weeks after postoperative rehabilitation treatment,a pulmonary function instrument was used to evaluate ratio of forced expiratory volume in 1 second to predicted value(FEV1%)and forced vital capacity in predicted value(FVC%).Forced expiratory volume per second/forced vital capacity(FEV1/FVC),maximum inspiratory pressure(MIP),six-minute walking distance(6MWD)and De Morton activity index(DEMMI)were used to determine motor function improvement,and hospitalization and inflammation indexes before and after treatment were analyzed.Results After 3 weeks of treatment,FEV1%,FVC%,FEV1/FVC,6MWD,and DEMMI of patients were significantly increased compared to before treatment(P<0.05),and indicators of EG were significantly better than those of CG after treatment.It was statistically significant(P<0.05).Peripheral blood WBC counts,PCT,and CRP after treatment were all lower than before treatment with statistically significant difference(P<0.05).Hospital stay in EG was shorter than that in CG with statistically significant difference(P<0.05).Conclusion Early quantitative pulmonary rehabilitation therapy after lung transplantation is more conducive to improving cardiopulmonary function,improving inflammation indicators,and shortening hospitalization.It is worthy of clinical promotion.