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心肺康复方案改善新冠后综合征患者的身体健康和生活质量。

Cardiopulmonary rehabilitation programme improves physical health and quality of life in post-COVID syndrome.

机构信息

Department of Public Health, Semmelweis University, Faculty of Medicine, Budapest, Hungary.

Department of Pulmonology, Semmelweis University, Budapest, Hungary.

出版信息

Ann Palliat Med. 2023 May;12(3):548-560. doi: 10.21037/apm-22-1143. Epub 2023 Mar 24.

Abstract

BACKGROUND

Many patients with previous COVID-19 infection suffer from prolonged symptoms after their recovery: cough, dyspnea, chest pain, shortness of breath, fatigue, anxiety or depression, regardless of milder or severe coronavirus infection. Review of the literature demonstrates underrepresented complex cardiopulmonary rehabilitation of patients with post-COVID syndrome. The aim of our quasi-experimental study was to evaluate the effectiveness of complex cardiopulmonary rehabilitation and to assess the quality of life, functional parameters before and after a 14-day specific cardiopulmonary rehabilitation and two months later.

METHODS

Sixty-eight patients participated in rehabilitation at Semmelweis University's Department of Pulmonology. Respiratory function: forced expiratory volume in 1 second (FEV1%pred), 6-minute walk test (6MWT), chest kinematics (CK), quality of life [EuroQol-5D (EQ-5D), Post-COVID-19 Functional Status (PCFS)] and Modified Medical Research Council (mMRC) dyspnea scale were measured at the beginning and end of the programme and two months after the rehabilitation.

RESULTS

The 14-day rehabilitation programme resulted in significant improvement of 6MWT {492 [interquartile range (IQR), 435-547] vs. 523 (IQR, 477-580) m; P=0.031}, mMRC [1 (IQR, 0.25-1) vs. 0 (IQR, 0-1); P=0.003], EQ-VAS score [75 (IQR, 65-80) vs. 85 (IQR, 75-90); P=0.015], and PCFS [1 (IQR, 1-2) vs. 0.5 (IQR, 0-1); P=0.032]. Respiratory function and chest kinematics also improved, FEV1(%pred) [86 (IQR, 73-103) vs. 91 (IQR, 80-99); P=0.360], chest kinematics [3.5 (IQR, 2.75-4.25) vs. 4 (IQR, 1-5.25) cm; P=0.296], and breath-holding test (BHT) [33 (IQR, 23-44) vs. 41 (IQR, 28-58) s; P=0.041].

CONCLUSIONS

Complex cardiopulmonary rehabilitation improved workload, quality of life, respiratory function, complaints and clinical status of patients with post-COVID syndrome. Personalized complex pulmonary rehabilitation can be beneficial and recommended for patients suffer from post-COVID syndrome, who have good potential for recovery and are able to participate in the two weeks complex pulmonary rehabilitation.

摘要

背景

许多曾感染过 COVID-19 的患者在康复后会出现长期症状:咳嗽、呼吸困难、胸痛、呼吸急促、疲劳、焦虑或抑郁,无论冠状病毒感染是轻度还是重度。对文献的回顾表明,患有新冠后综合征的患者的复杂心肺康复治疗代表性不足。我们的准实验研究旨在评估综合心肺康复的有效性,并评估患者在 14 天特定心肺康复前后和两个月后的生活质量和功能参数。

方法

68 名患者参加了塞梅尔维斯大学肺病学系的康复治疗。呼吸功能:一秒用力呼气量(FEV1%pred)、6 分钟步行试验(6MWT)、胸部运动学(CK)、生活质量[EuroQol-5D(EQ-5D)、新冠后功能状态(PCFS)]和改良医学研究委员会(mMRC)呼吸困难量表在项目开始和结束时以及康复后两个月进行测量。

结果

为期 14 天的康复计划显著改善了 6MWT[492(四分位距(IQR),435-547)vs.523(IQR,477-580)m;P=0.031]、mMRC[1(IQR,0.25-1)vs.0(IQR,0-1);P=0.003]、EQ-VAS 评分[75(IQR,65-80)vs.85(IQR,75-90);P=0.015]和 PCFS[1(IQR,1-2)vs.0.5(IQR,0-1);P=0.032]。呼吸功能和胸部运动学也有所改善,FEV1%(pred)[86(IQR,73-103)vs.91(IQR,80-99);P=0.360]、胸部运动学[3.5(IQR,2.75-4.25)vs.4(IQR,1-5.25)cm;P=0.296]和屏气试验(BHT)[33(IQR,23-44)vs.41(IQR,28-58)s;P=0.041]。

结论

综合心肺康复改善了新冠后综合征患者的工作负荷、生活质量、呼吸功能、主诉和临床状况。个性化的综合肺康复对有康复潜力且能够参加两周综合肺康复的新冠后综合征患者可能有益并值得推荐。

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