摘要
目的 :探讨中、重度慢阻肺 (COPD)患者气流阻塞的影响因素及康复治疗的指导意义。方法 :分别测定 10 1例中、重度慢阻肺患者的最大呼气流量 容积曲线并进行相关分析。结果 :中度COPD患者FEV1%仅与Vmax50 %呈正相关 (r=0 .4 76 ,P <0 .0 0 1) ;重度COPD患者FEV1%则与Vmax75%、Vmax50 %和Vmax2 5%皆呈正相关 (依次r =0 .70 5 ,P <0 .0 0 1;r =0 .5 6 9,P <0 .0 0 1;r =0 .4 2 1,P <0 .0 0 1)。另对 2 8例吸烟者FEV1%与吸烟时间、日吸烟量和戒烟时间所作的相关分析表明 ,FEV1%与这些因素都无明显的相关性。结论 :中度COPD的气流阻塞仅与小气道阻塞有关 ,缓解期的康复治疗保持气道的通畅至为重要 ;重度COPD的气流阻塞不但同时与大、小气道阻塞有关 ,还可能与呼吸肌的功能状态有关 ,其缓解期的康复治疗不但要保持气道的通畅 ,还需要进行呼吸肌的康复锻炼和配合营养支持 ,但仅有FEV1%数据也无法给患者提供有效的指导 ,呼吸肌功能测定极为必需 。
Objective: To investigate the influencing factors for airflow block in the patients with moderate or severe chronic obstructive pulmonary disease (COPD)and their roles in rehabilitation treatment. Methods: Maximal expiratoryflow volume curve was determined in 101 cases of moderate or severe COPD individually and the relative analysis made. Results: In the patients with moderate COPD, FEV 1 % was only positively related with V max50 % ( r = 0.476 , P < 0.001 ), while in those with severe COPD, FEV 1 % was positively related with V max75 %, V max50 % and V max25 % ( r = 0.705 , P < 0.001 ; r = 0.596 , P < 0.001 ; r = 0.421 , P < 0.001 , respectively). The relative analysis on FEV 1 % with smoking time, smoking number every day and smoking prohibiting time in 20 smoking cases of COPD revealed that EFV 1 % was not remarkably related to these factors. Conclusion: Airflow obstruction of moderate COPD was only related to the small airway block. During the remission duration, it was very important to retain unobstructed airway; Airflow obstruction of severe COPD was not only related to large or small airway obstruction simultaneously, but also the function of respiratory muscle. During the remission duration, the rehabilitation treatment included retaining the unobstructed airway, training respiratory muscle and strengthening nutritional support. Besides FEV 1 % data, function measurement of respiratory muscle was also very essential.
出处
《中国康复》
2002年第1期23-24,共2页
Chinese Journal of Rehabilitation
