Weekly Hospital-Based Pulmonary Rehabilitation for Chronic Obstructive Airway Disease Maintains Exercise Capacity and Reduces Hospitalization

對於慢性阻塞性氣道疾病者每周以醫院為基礎的肺部復健來維持運動容量及減少住院

李忠恕(Chung-Shu Lee) ； 鍾福財(Fu-Tsai Chung) ； 何淑娟(Shu-Chuan Ho) ； 謝孟亨(Meng-Heng Hsieh) ； 枋岳甫(Yueh-Fu Fang) ； 盛德芳(Te-Fang Sheng) ； 陳麗妃(Li-Fei Chen) ； 饒文琴(Wen-Ching Jao) ； 林鴻銓(Horng-Chyuan Lin)

《胸腔醫學》 32卷3期 (2017/06) Pp. 115-124

摘要

Introduction: This retrospective study aimed to evaluate the effects of a supervised, weekly, hospital-based pulmonary rehabilitation (PR) program on exercise capacity and clinical outcome in patients with chronic obstructive airway diseases (COAD) in a tertiary-care hospital in Taiwan. Methods: Eighty-four COAD patients were divided into PR (n=42) or non-PR (n=42) groups. Subjects in the PR group regularly took part in a once-a-week rehabilitation program in the hospital for a period of 12 months. Pulmonary function was measured and 6-minute walk tests were given every 3 months. Total duration and time of hospitalization and emergency room (ER) consultation were analyzed. Results: There was no demographic difference between the 2 groups. During the study period, the 6-minute walk distance increased in the PR group (from 402.5±18.3 to 410.4±17.8 meters), but significantly decreased in the non-PR group (from 430.7±12.8 to 376.0±24.9 meters, p＜0.05). Forced vital capacity was significantly higher in the PR group at 6 and 12 months, compared to the non-PR group. Hospital admissions and length of stay were significantly decreased in the PR group compared to the non-PR group (0.29±0.55 vs. 0.64±1.02 visits and 1.88±4.16 vs. 6.71±14.82 days, respectively, p＜0.05). Subjects in the PR group also had a lower rate and duration of ER visits than those in the non-PR group (0.24±0.53 vs. 0.93±1.67 visits and 0.36±0.88 vs. 2.12±4.17 days, respectively, p＜0.05). Conclusion: Weekly hospital-based PR can maintain functional exercise capacity and improve pulmonary function in COAD patients. Hospital and ER visits and length of stay were also reduced.

關鍵字

hospital-based pulmonary rehabilitation ； chronic obstructive airway diseases ； exercise capacity ； hospitalization ； pulmonary function

並列摘要

前言：這個在台灣三級照護醫院的回溯性研究，目標在評估一個每周以醫院為基礎的監督型肺部復健計畫，對於慢性阻塞性氣道患者的運動容量和臨床表現。方法：84 位慢性阻塞性氣道患者分成復健組(PR) 42 人和非復健組(non-PR) 42 人。復健組中患者接受復健計畫達12 個月。每三個月肺功能和六分鐘走路測驗會進行一次檢測。另外，將分析全部的住院時間和急診會診。結果： 在肺部復健計畫期間， 在復健組六分鐘走路測驗中的距離是維持著( 從402.5±18.3 到410.4±17.8 公尺)，但非復健組則明顯下降( 從430.7±12.8 至376.0±24.9 公尺，p＜0.05)。就用力肺活量(Forced vital capacity, FVC) 而言，在六個月和十二個時復健組較非復健組大。PR 的每人每年住院次數和住院天數明顯地比non-PR 減少( 分別為0.29±0.55 vs. 0.64±1.02 次和1.88±4.16 vs. 6.71±14.82 天，p＜0.05)。相較於non-PR，觀察的PR 病人有較低的每人每年急診就醫次數和較少的急診天數 ( 分別為0.24±0.53 vs.0.93±1.67 次和0.36±0.88 vs. 2.12±4.17 天，p＜0.05)。結論：在慢性阻塞性氣道患者中，以每周醫院為基礎的肺部復健能維持功能性運動容量和改善肺功能。同時，醫院和急診的就醫次數和住院天數也減少。

並列關鍵字

醫院為基礎的肺部復健 ； 慢性阻塞性氣道疾病 ； 運動容量 ； 住院 ； 肺功能