分级运动康复对慢性阻塞性肺疾病急性加重期患者的效果评价

doi:10.3761/j.issn.0254-1769.2025.09.006

摘要/Abstract

摘要：

目的探讨分级运动康复对慢性阻塞性肺疾病急性加重期患者的影响，为临床护理实践提供参考。方法采用便利抽样法，选取2023年9月—12月遵义市某三级甲等医院呼吸内科的70例慢性阻塞性肺疾病急性加重期患者为研究对象，随机分为试验组和对照组（每组各35例），试验组实施基于“全球慢性阻塞性肺疾病倡议指南2023版”下的分级运动康复，对照组实施常规运动康复，两组均干预至出院。干预后，比较两组肺功能、血气分析、氧合指数、运动耐力、无创机械通气相关并发症发生率。结果最终试验组纳入34例，对照组纳入35例。干预后，试验组第1秒用力呼气容积较对照组有所改善（P<0.05）；试验组6 min步行试验距离优于对照组（P<0.05）；试验组无创机械通气相关并发症总发生率较对照组低（P<0.05）；两组血气分析、氧合指数比较，差异无统计学意义（P>0.05）。结论实施基于全球慢阻肺倡议指南下的分级运动康复能帮助慢性阻塞性肺疾病急性加重期患者改善呼吸功能，提高运动耐力，减少无创机械通气相关并发症的发生。

关键词: 急性加重期, 肺疾病，慢性阻塞性, 分级运动康复, 护理

Abstract:

Objective To analyze the effect of graded exercise rehabilitation in patients with acute exacerbation of chronic obstructive pulmonary disease，and to provide references for clinical nursing practice. Methods A total of 70 patients with acute exacerbation of chronic obstructive pulmonary disease who met the criteria in the Department of Respiratory Medicine of a tertiary hospital in Zunyi City from September to December 2023 were randomly divided into an experimental group and a control group（with 35 cases in each group）. The experimental group implemented graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines，and the control group implemented routine exercise rehabilitation. After intervention，the lung function，blood gas analysis，oxygenation index，6 min walking test and the incidence of complications related to non-invasive mechanical ventilation were compared between the 2 groups. Results Finally，34 cases were included in the experimental group and 35 cases in the control group. After intervention，the forced expiratory volume in the first second of the experimental group was improved compared with the control group （P<0.05）. The 6-minute walking test of the experimental group was higher than that of the control group（P<0.05）. The total incidence of non-invasive mechanical ventilation-related complications in the experimental group was lower than that in the control group（P<0.05）. There was no significant difference in blood gas analysis and oxygenation index between the 2 groups（P<0.05）. Conclusion The implementation of graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines can help patients with acute exacerbation of chronic obstructive pulmonary disease improve their respiratory function，improve their exercise endurance，and reduce non-invasive mechanical ventilation-related complications.

Key words: Acute Exacerbation, Pulmonary Disease，Chronic Obstructive, Graded Exercise Rehabilitation, Nursing Care

杨娜娜, 程传丽, 曾慧, 符丹丹, 王燕, 陈悦, 冉宏敏, 范红静, 龙霞. 分级运动康复对慢性阻塞性肺疾病急性加重期患者的效果评价[J]. 中华护理杂志, 2025, 60(9): 1062-1067.

YANG Nana, CHENG Chuanli, ZENG Hui, FU Dandan, WANG Yan, CHEN Yue, RAN Hongmin, FAN Hongjing, LONG Xia. Evaluation of the effect of graded exercise rehabilitation on patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Chinese Journal of Nursing, 2025, 60(9): 1062-1067.

图/表 5

表1 慢性阻塞性肺疾病急性加重期患者分级运动康复干预方案

Table 1 Graded exercise rehabilitation for patients with AECOPD

表2 两组一般资料的比较[例（百分比，%）]

Table 2 Comparison of general data between the 2 groups[case（percentage，%）]

表3 干预后两组肺功能的比较（$\bar{x} \pm s$）

Table 3 Comparison of pulmonary function between the 2 groups after intervention（$\bar{x} \pm s$）

表4 干预前后两组血气分析和氧合指数的比较（mmHg，$\bar{x} \pm s$）

Table 4 Comparison of blood gas analysis and oxygenation index between the 2 groups（mmHg，$\bar{x} \pm s$）

表5 干预前后两组6 min步行试验距离的比较（m，$\bar{x} \pm s$）

Table 5 Comparison of 6-minute walking distance between the 2 groups before and after intervention （m，$\bar{x} \pm s$）

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