肺康复对慢性呼吸系统疾病患者肺功能和生活质量的影响

Bhagyashri Karande, Nayana Gosavi, Ajay Godse
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引用次数: 0

摘要

慢性肺病患者通常表现为呼吸困难、咳嗽、疲劳、身体受限和生活质量(QoL)低下。由于这些病症和身体上的限制,他们可能很难进行日常活动。伦敦胸部活动日常生活(LCADL)量表可评估慢性呼吸系统疾病患者在日常生活(ADL)中自我报告的呼吸困难情况。该研究旨在评估肺康复对呼吸困难等级(mMRC 量表)、生活质量参数(即 LCADL 量表、6 分钟步行测试(6MWT)和肺功能(FEV1 和 FVC))的影响。该研究是一项回顾性观察研究,在 Bhakti Vedanta 医院和研究所肺病科进行,为期一年。患有慢性阻塞性肺病(COPD)、间质性肺病(ILD)、卵巢囊肿后肺功能障碍等不同肺部疾病的患者被纳入研究。共有 80 名患者被转诊至肺康复中心(PR)。其中,40 名患者完成了为期 8 周的康复计划。研究对象的分布情况如下:18 名慢性阻塞性肺病患者,13 名 ILD 患者,9 名其他肺部疾病患者。15名患者需要氧气支持,因为他们在室内空气中的血氧饱和度(SpO2)基线低于90%。总体而言,在为期 8 周的肺康复计划中,生活质量指标如 LCADL 评分、mMRC、6MWT 和肺功能(FEV1、FVC)均有显著的统计学差异。完成为期 8 周的肺康复(PR)计划后,国内、体力活动在所有参数上的得分都更高。mMRC 量表上的呼吸困难等级从 1.9 ± 0.591 降至 0.45 ± 0.50。P值具有统计学意义(P < 0.001)。6 MWT 距离从 169.5 米增加到 8 周后的 324.5 米,平均相差 155 米,具有统计学意义。6MWT 距离的 p 值(< 0.001)。在肺功能方面,FEV1 从预测值的 52.30% 提高到 56.73%,FVC 从预测值的 56.20% 提高到 58.20%。FEV1和FVC的平均差异分别为4.43和2.0。 研究结果表明,为期8周的肺康复项目不仅能减轻慢性呼吸系统疾病患者的症状,还能提高其运动能力,并对其生活质量和肺功能产生积极影响。
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Impact of pulmonary rehabilitation on lung functions and quality of life in chronic respiratory disease patients
Patients with chronic pulmonary disease commonly present with dyspnea, cough, fatigue, physical limitations, and low Quality-of-Life (QoL). With these morbidities and physical limitations, it may be difficult to perform their day-to-day activities. The London Chest Activity Daily Living (LCADL) scale assesses the self-reported dyspnea of patients with chronic respiratory disease during Activities of Daily Living (ADL). The study was designed to assess the impact of pulmonary rehabilitation on the dyspnea grade (mMRC scale), the Quality-of-Life parameters viz LCADL scale, 6 Minute Walk Test (6MWT) and lung functions (FEV1 & FVC).The study is a retrospective observational study conducted over a period of 1 year, at the Department of Pulmonology, Bhakti Vedanta Hospital & Research Institute. Patients with different pulmonary conditions such as Chronic Obstructive Pulmonary Disease (COPD), Interstitial Lung Disease (ILD), Post-covid Lung Dysfunction, etc. were enrolled in the study. A total of 80 patients were referred to Pulmonary Rehabilitation (PR). Out of which, 40 patients completed an 8-week program. The distribution of the study population was as follows: 18 patients with COPD, 13 patients with ILD, 9 patients with other pulmonary diseases. 15 patients required oxygen support where oxygen saturation (SpO2) was < 90% at baseline at room air. The outcome measures were assessed in these patients at the time of enrollment (Week 0) and at the end of the program (Week 8).Overall, the statistically significant difference noted in Quality-of-Life parameters like LCADL score, mMRC, 6MWT, and lung functions (FEV1, FVC) with an 8-week Pulmonary Rehabilitation program.The p-value (< 0.001) was found in London Chest Activity Daily Living (LCADL) score. Domestic, physical activity had better scores with respect to all parameters after completion of the 8-week Pulmonary Rehabilitation (PR) program. The dyspnea grade on the mMRC scale improved from 1.9 ± 0.591 to 0.45 ± 0.50. The p-value was statistically significant (p < 0.001). 6 MWT distance was improved from 169.5 meters to 324.5 meters at the completion of 8-weeks, the mean difference was 155 meters which was found to be statistically significant. The p-value (< 0.001) was found in 6MWT distance. In lung functions, FEV1 improved from 52.30 % to 56.73 % of predicted and FVC improved from 56.20 % to 58.20 % of predicted. The mean difference of FEV1 and FVC was 4.43 to 2.0, respectively. : An 8-week supervised pulmonary rehabilitation program has demonstrated that the inclusion of pulmonary rehabilitation, not only reduces the symptoms but also improves the exercise capacity and add significant positive effect on the quality of life as well as lung functions in patients with chronic respiratory disease.
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