摘要
目的探讨医护人员督导下的医院-家庭持续肺康复训练联合心理干预对慢性阻塞性肺疾病(COPD)患者运动能力、急性加重次数和焦虑抑郁情绪的影响。方法采用前瞻性随机对照研究,选取2016年11月至2018年11月该院收治的68例COPD患者为研究对象,最终60例患者达到观察终点,其中试验组33例,对照组27例。所有患者先接受2周的院内肺康复训练,试验组给予医院-家庭督导式肺康复训练联合心理干预,对照组给予单纯药物治疗,无医护人员督导。干预前及干预1年后,测试6 min步行试验步行距离(6MWTD)、第1秒用力呼气容积占预计值百分比(FEV1%pre)、动脉血氧分压(PaO2)、圣乔治呼吸问卷(SGRQ)评分,记录患者急性加重次数,采用患者健康问卷抑郁量表(PHQ-9)、广泛性焦虑量表(GAD-7)评估患者的抑郁及焦虑程度。结果干预后,试验组6MWTD、PaO2、FEV1%pre较干预前明显升高,且明显高于对照组(P<0.05);试验组SGRQ症状、活动能力、疾病影响3个维度评分均降低,且干预前后疾病影响、活动能力评分比较,差异有统计学意义(P<0.05);试验组PHQ-9、GAD-7评分均明显降低(P<0.05)。与干预前比较,干预后试验组年急性加重次数明显减少[(1.25±0.46)次vs.(0.25±0.46)次,P<0.05],对照组干预前后无明显差异[(1.33±0.51)次vs.(1.00±0.89)次,P>0.05]。结论在医护人员督导下开展家庭肺康复训练联合心理干预可以提高COPD患者的运动能力,改善肺功能,减少急性加重次数,缓解患者焦虑、抑郁情绪。
Objective To investigate the effects of hospital-family continuous pulmonary rehabilitation training combined with psychological intervention under the supervision of medical staff on exercise ability,frequency of acute exacerbations,anxiety and depression in patients with chronic obstructive pulmonary disease(COPD).Methods Randomized controlled clinical trial was used in the study.A total of 68 cases of COPD patients admitted to the hospital from November 2016 to November 2018 were selected as the study objects,and 60 cases finally reached the observation endpoint,including 33 cases in the experimental group and 27 cases in the control group.All patients received in-hospital pulmonary rehabilitation training for 2 weeks.The experimental group was given hospital-family supervised pulmonary rehabilitation training combined with psychological intervention,while the control group was given simple drug therapy without supervision by medical staff.Before and after intervention in 1 year,6 min walking distance(6 MWTD),percentage of forced expiratory volume in 1 second of expected value(FEV1%pre),arterial blood oxygen partial pressure(PaO2),st George′s respiratory questionnaire(SGRQ)score were tested,frequency of acute exacerbations was recorded,and the patient health questionnaire depression scale(PHQ-9),generalized anxiety scale(GAD-7)evaluation of patients were tested for measuring depression and anxiety.Results After intervention,6MWTD,PaO2 and FEV1%pre in the experimental group significantly increased compared with those before intervention,andwere significantly higher than those in the control group(P<0.05).The scores of SGRQ symptoms,activity ability and disease influence in the experimental group were all reduced,and the differences of disease influence and activity ability scores before and after intervention were statistically significant(P<0.05).PHQ-9 and GAD-7 scores in the experimental group were significantly decreased(P<0.05).Compared with before intervention,frequency of acute exacerbations in the expe
作者
向晋
罗春
江宇
XIANG Jin;LUO Chun;JIANG Yu(Department of Respiratory and Critical Care,University-Town Hospital of Chongqing Medical University,Chongqing 401331,China)
出处
《重庆医学》
CAS
2021年第1期92-96,共5页
Chongqing medicine
基金
重庆市卫生和计划生育委员会面上项目(2016MSXM057)。
关键词
慢性阻塞性肺疾病
肺康复
心理干预
chronic obstructive pulmonary disease
pulmonary rehabilitation
psychological intervention
