综合性肺康复疗法对老年COPD稳定期肺部感染患者运动能力和生存质量的影响

Effect of comprehensive pulmonary rehabilitation on exercise capacity and quality of life in elderly patients with stable COPD infection

  • 摘要: 目的 探讨综合性肺康复疗法对老年慢性阻塞性肺疾病(Chronic obstructive pulmonary disease, COPD)稳定期肺部感染患者运动能力和生存质量的影响。方法 选择2016年1-12月医院收治的老年COPD稳定期合并肺部感染患者128例,分为试验组与对照组,各64例。对照组患者采用常规治疗,试验组在对照组的基础上结合综合性肺康复疗法治疗。两组疗程均为12周。观察病原菌分布情况,比较两组疗效,治疗前后肺功能、运动能力及生存质量改善情况。结果 128例患者共培养分离病原菌109株,其中革兰阴性菌75株占68.81%、革兰阳性菌28株占25.69%、真菌6株占5.50%;试验组疗效优于对照组(P<0.05);治疗后两组患者各项指标与治疗前比较均有改善(P<0.05);其中试验组治疗后FEV1、PEF、FEV1/FVC分别为(1.74±0.38)L、(3.38±0.49)L、(81.35±5.46)%高于对照组(P<0.05);试验组治疗后6MWT为(376.42±29.81)m高于对照组,而CAT为(8.14±1.37)分低于对照组(P<0.05);试验组治疗后生存质量评分总分为(122.03±7.51)分高于对照组,且质量各项评分优于对照组(P<0.05)。结论 综合性肺康复疗法对老年COPD稳定期合并肺部感染患者疗效较好,且可改善患者运动能力和生存质量。

     

    Abstract: OBJECTIVE To investigate the effect of comprehensive pulmonary rehabilitation on exercise capacity and quality of life in elderly patients with chronic obstructive pulmonary disease (COPD) and stable pulmonary infection. METHODS A total of 128 cases of elderly patients with stable COPD combined with pulmonary infection in our hospital from Jan. 2016 to to Dec. 2016 were selected and divided into experimental group (n=64) and control group (n=64). Patients in the control group were treated with conventional therapy, while patients in the experimental group were treated with comprehensive pulmonary rehabilitation based on the control group. The course of treatment was 12 weeks in the two groups. The distribution of pathogenic bacteria was observed, and the therapeutic effects of the two groups were compared. The improvement of pulmonary function, exercise capacity and survival quality were observed before and after treatment. RESULTS A total of 109 strains of pathogenic bacteria were isolated from 128 patients, including 75 strains of gram-negative bacteria accounting for 68.81%, 28 strains of gram-positive bacteria accounting for 25.69%, and 6 strains of fungi accounting for 5.50%. The curative effect of the experimental group was significantly better than that of the control group (P<0.05). After treatment, the indexes of the two groups were significantly improved compared with those before treatment (P<0.05). The FEV1, PEF and FEV1/FVC of the experimental group after treatment were (1.74±0.38)L, (3.38±0.49)L, and (81.35±5.46)%, which were significantly higher than those of the control group (P<0.05).The 6MWT of the experimental group after treatment was (376.42±29.81) m, which was significantly higher than that of the control group, and the CAT of the experimental group was (8.14±1.37) points, which was significantly lower than that of the control group (P<0.05). The quality of life score of the experimental group after treatment was (122.03±7.51) points, which was significantly higher than that of the control group, and each score of quality was significantly better than that of the control group (P<0.05). CONCLUSION Comprehensive pulmonary rehabilitation has good efficacy in elderly patients with chronic obstructive pulmonary disease (COPD) patients and stable pulmonary infection, and can significantly improve the exercise capacity and quality of life in patients.

     

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