肺康复训练对尘肺合并COPD病人肺功能及生活质量的影响

Effect of pulmonary rehabilitation training on lung function and quality of life of pneumoconiosis patients complicated with COPD

[目的]探讨肺康复训练对尘肺合并慢性阻塞性肺疾病(COPD)病人肺功能及生活质量的影响。[方法]将86例尘肺合并COPD病人随机分为康复训练组和对照组各43例。对照组采用常规的呼吸内科护理,包括药物指导、饮食护理、心理护理以及氧疗;康复训练组在对照组护理基础上增加肺康复训练,包括有氧运动、呼吸锻炼、咳嗽训练及排痰训练。干预8周后,测评病人肺功能、血气分析、生活质量。[结果]康复训练组接受干预后,第1秒用力呼气容积(FEV1)、第1秒用力呼气容积/用力肺活量比值(FEV1/FVC)、6min步行距离均高于对照组,动脉血氧分压(PaO_2)明显上升、动脉血二氧化碳分压(PaCO_2)明显下降,总体生活质量评分和其他维度评分高于对照组。[结论]肺康复训练能够显著改善尘肺合并COPD病人肺功能和运动耐量,纠正缺氧和二氧化碳潴留,改善病人生活质量。

Objective:To investigate the effect of pulmonary rehabilitation training on lung function and quality of life in patients with pneumoconiosis complicated with chronic obstructive pulmonary disease(COPD).Methods:A total of 86 patients with pneumoconiosis combined with COPD were randomly divided into rehabilitation training group and control group,43 cases in each group.The patients in control group received routine respiratory medical care,including drug guidance,diet care,psychological care and oxygen therapy.The patients in rehabilitation training group received additional lung function rehabilitation training based on the same care in the control group,including aerobics,breathing exercises,cough training and sputum training.After 8 weeks of intervention,the patient’s lung function,dynamic gas analysis and quality of life were assessed.Results:After the intervention,in the rehabilitation group the forced expiratory volume(FEV1)in the first second,the forced expiratory volume in the first second/forced vital capacity(FEV1/FVC),and the walking distance in 6 minutes were improved significantly compared those in control group;in the rehabilitation group PaO2 appeared obvious ascending,PaCO2 showed a significant decline,and the overall quality of life score and other dimension scores were also higher than those in control group(P<0.05,P<0.01).Conclusions:Pulmonary rehabilitation training could significantly improve lung function and exercise tolerance in patients with pneumoconiosis complicated with COPD,correct hypoxia and carbon dioxide retention,and improve the quality of life of patients.