与 COVID-19 有关的肺间质损伤中度病程医务工作者的 I 期康复疗效

L. A. Shpagina, V. Drobyshev, S. Karmanovskaya, E. Loktin, I. Shpagin, O. Kotova, L. Panacheva, T. V. Musienko, E. A. Zaikina
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摘要

本研究旨在评估重症监护病房中因新型冠状病毒感染导致重度或中度肺损伤的医务工作者早期康复方法的有效性,以改善肺通气、气体交换和支气管清除,纠正肌无力,提高整体身体耐力、活动能力、心理情绪稳定性。我们对 53 名 COVID-19 女性中度肺损伤患者进行了第一阶段康复治疗,分为两组:主要组(n = 31,医务人员)和对照组(n = 22,从事与肺部危险因素无关的工作,包括无 SARS-CoV-2 感染风险)。早期康复在重症监护室和市第二临床医院传染病医院进行,COVID-19 患者的康复计划是根据新型冠状病毒感染医疗康复暂行指南制定的。结果表明,在重症监护室和专业科室条件下进行康复治疗,可以明显减轻呼吸困难、焦虑和抑郁的严重程度,对运动耐量的提高产生积极影响,并有助于降低全身炎症的活动。在与 COVID-19 患者有工业接触的患者中,康复措施的有效性低于对比组。为了提高COVID-19和肺损伤医务工作者第一阶段康复的效果,有必要进行比现行指南更密集、更长时间的康复。
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Efficacy of stage I rehabilitation of medical workers with moderate course of interstitial lung damage associated with COVID-19
Aim of the study was to evaluate the effectiveness of early rehabilitation methods for medical workers with severe or moderate lung damage caused by a new coronavirus infection, who are in intensive care units, to improve lung ventilation, gas exchange and bronchial clearance, correct muscle weakness, increase overall physical endurance, mobility, psycho-emotional stability.Material and methods. We examined 53 COVID-19 women with moderate lung injury at stage I of rehabilitation, divided into two groups: main (n = 31, medical personnel) and control (n = 22, working outside of contact with pulmotropic risk factors, including no risk of SARS-CoV-2 infection). Early rehabilitation was carried out in the intensive care unit and in the infectious diseases hospital of City Clinical Hospital No. 2, for patients with COVID-19 rehabilitation plan was drawn up in accordance with temporary guidelines for the medical rehabilitation of a new coronavirus infection.Results and discussion. It was established, that rehabilitation in the conditions of the intensive care unit and the specialized department can significantly reduce the severity of dyspnea, anxiety and depression, positively affects the increase in exercise tolerance, and helps to reduce the activity of systemic inflammation. In patients who have industrial contact with patients with COVID-19, the effectiveness of rehabilitation measures is lower than in the comparison group.Conclusions. To increase the effectiveness of stage I of the rehabilitation of medical workers with COVID-19 and lung damage, it is necessary to conduct more intensive and longer rehabilitation than indicated in the current guidelines.
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