基于GOLD分级的肺康复训练在慢性阻塞性肺疾病急性加重期患者中的应用研究

Effect of pulmonary rehabilitation training based on GOLD classification in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨基于慢性阻塞性肺疾病全球倡议(GOLD)分级的肺康复训练对慢性阻塞性肺疾病急性加重期(AECOPD)患者自我效能及康复效果的影响。方法采用便利抽样法选择2019年5月—2021年4月吉林大学中日联谊医院收治的AECOPD患者85例,采用随机数字表法分为试验组43例、对照组42例。对照组给予患者常规肺康复训练,试验组给予基于GOLD分级的肺康复训练。训练2周后,比较两组自我效能、肺功能及6 min步行距离(6MWT)、生活质量、不良反应情况。结果干预2周末,试验组呼吸困难管理、情绪、体力活动、安全行为、自我效能总分高于对照组,差异有统计学意义(P<0.05);试验组第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、6MWT高于对照组,差异有统计学意义(P<0.05);试验组呼吸症状、活动受限、疾病对生活影响、圣乔治呼吸问卷(SGRQ)总分低于对照组,差异有统计学意义(P<0.05)。两组患者均未出现严重不良反应。结论基于GOLD分级的肺康复训练有助于提高AECOPD患者自我效能水平,促进肺功能恢复,改善患者生活质量,安全性良好。

Objective To explore the effect of pulmonary rehabilitation training based on Chronic Obstructive Pulmonary Disease(GOLD)classification on self-efficacy and rehabilitation effect in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods From May 2019 to April 2021,a total of 85 patients with acute exacerbation of chronic obstructive pulmonary disease who were admitted to China-Japan Union Hospital of Jilin University were selected and divided into the observation group(43 cases)and the control group(42 cases)using the random number table method.The control group received routine pulmonary rehabilitation training,and the observation group conducted pulmonary rehabilitation training based on GOLD classification.Two weeks after intervention,the self-efficacy,pulmonary function,6-Minute Walking Test(6MWT),quality of life,and the condition of adverse reactions were compared between the two groups.Results Two weeks after intervention,the scores of dyspnea management,emotion,physical activity,safety behavior,and total score of self-efficacy of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The forced exhalation volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC and 6MWT of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The scores of respiratory symptoms,activity limitation,disease impact on life and total score of St.George's Respiratory Questionnaire(SGRQ)of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).There were no serious adverse reactions in two groups.Conclusions Pulmonary rehabilitation training based on GOLD classification can help patients'promote the recovery of lung function,improve their self-efficacy and the quality of life,which has good security.