慢性阻塞性肺疾病急性加重期患者分级化肺康复的临床研究

发布时间：2018-02-11 23:26

本文关键词： 肺疾病慢性阻塞性急性加重期运动自我效能感肺康复　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:调查急性加重期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者运动自我效能感及其影响因素;探讨适用于COPD急性加重期患者的以运动训练为基础的分级化肺康复的策略,并评估其有效性。方法:(1)采用方便抽样对重庆医科大学附属第二医院呼吸内科门诊及病房中确诊为COPD急性加重期的126例患者进行一般资料问卷、运动自我效能感量表及社会支持评定量表调查。(2)使用随机数字表法,将其中符合纳入排除标准的68例COPD急性加重期住院患者分为康复组35例与对照组33例。对两组均进行常规的治疗护理措施,而康复组在对此基础上行分级化肺康复运动。对两组治疗前后的医院焦虑抑郁量表、BODE指数以及COPD临床问卷得分以及变化幅度进行比较。结果:(1)COPD急性加重期患者的运动自我效能感平均分为(79.97±19.78)分,属于中等水平。多因素分析显示,社会支持评价、其他疾病、年龄以及睡眠障碍是影响COPD急性加重期患者运动自我效能感的主要影响因素(t=5.351、3.469、-3.082、2.461,P0.01或0.05)。(2)COPD急性加重期患者分级化肺康复运动实验中共完成61例,康复组31例,对照组30例。干预后康复组医院焦虑抑郁量表评分从基线的7.67±3.92到康复后的6.45±4.25(P0.01),BODE指数从7.58±2.11到康复后的7.10±2.33(P0.01),COPD临床问卷从基线的2.82±1.27到康复后的2.67±1.27(P0.01);实验组和对照组的变化幅度比较中BODE指数有统计学意义(P0.05)。而对照组前后变化幅度比较无统计学意义(P0.05)。结论:(1)COPD急性加重期患者的运动自我效能感处于中等水平,亟待提高,更应特别关注社会支持体系和对其他疾病的控制;(2)急性加重期COPD患者经过分级化肺康复后可获得心理状态、运动能力及生活质量的改善。
[Abstract]:Objective: to investigate the motor self-efficacy and its influencing factors in patients with chronic obstructive pulmonary disease of acute exacerbation of COPD, and to explore the strategies of graded pulmonary rehabilitation based on exercise training for patients with acute exacerbation of COPD. Methods: to evaluate its effectiveness, 126 patients with acute exacerbation of COPD in outpatient and ward department of Department of Respiratory Medicine, second affiliated Hospital of Chongqing Medical University were surveyed with general data questionnaire. Exercise self-efficacy scale and social support rating scale. 68 inpatients with acute exacerbation of COPD were divided into rehabilitation group (n = 35) and control group (n = 33). On the basis of this, the rehabilitation group was treated with graded pulmonary rehabilitation exercise. The BODE index of hospital anxiety and depression scale and the scores and changes of COPD clinical questionnaire were compared between the two groups before and after treatment. The average score of motor self-efficacy was 79.97 卤19.78. Multivariate analysis shows that social support evaluation, other diseases, Age and sleep disorder were the main influencing factors of motor self-efficacy in patients with acute exacerbation of COPD. The scores of hospital anxiety and depression scale after intervention in rehabilitation group ranged from 7.67 卤3.92 in baseline to 6.45 卤4.25 in P0.01BDE index after rehabilitation from 7.58 卤2.11 to 7.10 卤2.33 P0.01 after rehabilitation from 2.82 卤1.27 in baseline to 2.67 卤1.27 in rehabilitation group, and the range of changes in experimental group and control group was significant. There was significant difference in BODE index between two groups (P 0.05), but there was no significant difference between control group (P 0.05) and control group (P 0.05). Conclusion the motor self-efficacy of patients with acute exacerbation of BODE is at a moderate level. We should pay more attention to the improvement of social support system and control of other diseases. The patients with COPD in acute exacerbation stage can obtain the improvement of mental state, motor ability and quality of life after grade lung rehabilitation.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9

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