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目的探讨多学科综合呼吸康复对老年重度慢性阻塞性肺疾病(COPD)的康复效果。方法将30例缓解期老年重度COPD住院患者分成综合呼吸康复组(康复组,20例)和对照组(10例)。康复组采用健康教育、运动训练、服药指导及营养指导等综合康复,对照组采用内科常规用药。治疗前、后2组均评定呼吸困难(采用Borg评分)、生存质量(QOL)、日常生活活动(ADL)、运动耐力(应用6min步行距离,6MWD)和肺功能,并进行组内与组间比较。结果治疗前2组的Borg评分、QOL、ADL、6MWD及肺功能差异无统计学意义(P＞0．05)。治疗3个月后,康复组的Borg评分明显降低,6MWD明显增加,与治疗前比较,差异均有统计学意义(P＜0．01),QOL和ADL也有明显提高,与治疗前比较,差异均有统计学意义(P＜0．05),而肺功能无明显改善。结论多学科综合呼吸康复虽不能使老年重度COPD患者的肺功能得到改善,但能使患者的呼吸困难症状减轻,生存质量提高,运动耐力改善及ADL能力增强。
Objective To investigate the effect of multidisciplinary comprehensive respiratory rehabilitation on elderly patients with severe chronic obstructive pulmonary disease (COPD). Methods Thirty patients with severe COPD in remission were divided into general respiratory rehabilitation group (rehabilitation group, 20 cases) and control group (10 cases). The rehabilitation group adopted the comprehensive rehabilitation of health education, exercise training, medication guidance and nutrition guidance, while the control group used conventional medicine. Respiratory dysfunction (using Borg score), quality of life (QOL), activities of daily living (ADL), exercise tolerance (using 6min walking distance, 6MWD) and pulmonary function were assessed before and after treatment in both groups. Compare Results There was no significant difference in Borg score, QOL, ADL, 6MWD and pulmonary function between the two groups before treatment (P> 0.05). After 3 months of treatment, the Borg score of the rehabilitation group was significantly lower, 6MWD was significantly increased, compared with before treatment, the differences were statistically significant (P <0.01), QOL and ADL also significantly increased, compared with before treatment, the difference All were statistically significant (P <0.05), while no significant improvement in lung function. Conclusions Although the multidisciplinary comprehensive respiratory rehabilitation can not improve the lung function of elderly patients with severe COPD, it can alleviate the symptoms of dyspnea, improve the quality of life, improve the exercise tolerance and enhance the ability of ADL.