多学科协作指导的家庭肺康复锻炼对慢性阻塞性肺疾病患者肺功能及生活质量的影响

The effect of home pulmonary rehabilitation exercise guided by multi-disciplinary team on pulmonary function and quality of life of patients with chronic obstructive pulmonary disease

目的探讨多学科协作(MDT)指导的家庭肺康复锻炼在慢性阻塞性肺疾病(COPD)患者中的干预效果。方法86例COPD患者,按随机数字表法分为对照组和观察组,每组43例。对照组患者给予常规干预,观察组患者给予MDT指导的家庭肺康复锻炼。对比两组锻炼依从性及干预前后肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC]、生活质量。结果观察组锻炼总依从率为95.35%,高于对照组的81.40%,差异具有统计学意义(P<0.05)。干预后,两组患者FVC、FEV1、FEV1/FVC高于本组干预前,6 min步行距离长于本组干预前,且观察组患者FVC(3.69±0.47)L、FEV1(2.86±0.45)L、FEV1/FVC(76.15±5.20)%高于对照组的(3.17±0.23)L、(2.18±0.37)L、(68.99±6.77)%,6 min步行距离(464.65±67.08)m长于对照组的(405.91±57.94)m,差异具有统计学意义(P<0.05)。干预后,两组患者疾病影响、活动能力、呼吸症状评分均低于本组干预前,且观察组患者疾病影响评分(6.39±0.72)分、活动能力评分(12.63±2.59)分、呼吸症状评分(9.24±1.75)分低于对照组的(8.27±1.31)、(16.88±2.67)、(11.98±1.67)分,差异具有统计学意义(P<0.05)。结论MDT指导的家庭肺康复锻炼用于COPD患者干预中,能提升锻炼依从性,改善肺功能,增强机体运动耐力,并提高患者生活质量。

Objective To discuss the intervention effect of home pulmonary rehabilitation exercise guided by multi-disciplinary team(MDT)on pulmonary function and quality of life of patients with chronic obstructive pulmonary disease(COPD).Methods A total of 86 patients with COPD were divided into control group and observation group according to random numerical table,with 43 cases in each group.The control group was given routine intervention,and the observation group was given home pulmonary rehabilitation exercise guided by MDT.Both groups were compared in terms of exercise compliance,pulmonary function indicators[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC]and quality of life before and after the intervention.Results The total exercise compliance rate in the observation group was 95.35%,which was higher than that of 81.40%in the control group,and the difference was statistically significant(P<0.05).After the intervention,FVC,FEV1 and FEV1/FVC in both groups were higher than those before intervention in this group,and the 6-min walking distance was longer than that before intervention in this group;the observation group had FVC of(3.69±0.47)L,FEV1 of(2.86±0.45)L and FEV1/FVC of(76.15±5.20)%,which were higher than those of(3.17±0.23)L,(2.18±0.37)L and(68.99±6.77)%in the control group;the 6-min walking distance of(464.65±67.08)m in the observation group was longer than that of(405.91±57.94)m in the control group;the difference were statistically significant(P<0.05).After the intervention,the scores of disease impact,mobility and respiratory symptoms in both groups were lower than those before intervention in this group;the observation group had disease impact score of(6.39±0.72)points,mobility score of(12.63±2.59)points and respiratory symptom score of(9.24±1.75)points,which were lower than those of(8.27±1.31),(16.88±2.67)and(11.98±1.67)points in the control group;the differences were statistically significant(P<0.05).Conclusion MDT guided home pulmonary rehabilitation exercise for COPD patients can enhance exercise compliance,improve pulmonary function,enhance exercise tolerance,and improve the quality of life of patients.