多学科合作模式对老年中重度慢性阻塞性肺疾病患者康复作用的研究

目的 探讨多学科合作模式对老年中、重度慢性阻塞性肺疾病（COPD）的康复效果.方法 将80例老年中、重度COPD住院患者分为2组,多学科合作呼吸康复组（治疗组）45例,对照组35例.2组均采用常规临床治疗,治疗组在常规临床治疗基础上加用多学科合作综合康复措施,疗程均为3个月.比较治疗前、后2组BODE指数及生活质量指数.结果 治疗30、60 d后,治疗组6 min步行距离（6-MWT）、BMI、呼吸困难修正评分（MMRC）、BODE指数及圣乔治呼吸问卷总分与对照组同一时间相比,差异均有统计学意义（P＜0.05）;治疗90 d后,治疗组上述各项指标与对照组相比[（463.0±35.1）m比（311.0±33.7）m,（22.0±4.1）kg/m2比（20.0±3.8）kg/m2,（2.0±0.8）分比（3.0±0.9）分,（3.0±1. 0）分比（7.6±0.9）分,（40.6±7.5）分比（52.8±4.8）分],差异均有统计学意义（均P＜0.01）.对照组治疗30、60、90 d后的6-MWT与治疗前相比,差异亦有统计学意义（P＜0.05）.结论 采用多学科合作模式对老年中、重度COPD患者进行呼吸康复训练,能明显降低患者的BODE指数,改善COPD患者的呼吸困难症状,提高患者生存质量.

Effects of multidisciplinary team model on old patients with moderate and severe COPD in respiratory rehabilitation training

Objective To investigate the effects of multidisciplinary team approach for rehabilitation of (multidisciplinary collaborative rehabilitation)old patients with moderate and severe chronic obstructive pulmonary disease (COPD). Methods Eighty old inpatients with moderate and severe COPD were divided into multidisciplinary team respiratory rehabilitation group (45 cases) and control group (35 cases). The two groups ali had routine treatment for 3 months with the respiratory rehabilitation group meanwhile also underwent comprehensive rehabilitation. BODE index and Quality of Life (QOL) scores before and after treatment were compared. Results Thirty and sixty days after treatment, 6 minute walk test (6-MWT), body mass index, MMRC, BODE index, and SGRQ scores of rehabilitation group were all different from those of control ( P ＜0.05). Ninety days after treatment, the above-mentioned indices of rehabilitation group were all different from those of control ( P ＜ 0. 01 ). 6-MWT of control group 30, 60, 90 days after treatment also was significantly different from that before treatment ( P ＜ 0. 05 ).Conclusion Multidisciplinary coordination in respiratory rehabilitation training of old patients with moderate and severe COPD can significantly lowered BODE score, improve dyspnea and increase quality of life.