| 刘贵容,任宇基,郑海清,任芳菲,张 彤,邹云山,胡昔权.康复训练对肝移植术后患者肺功能和运动功能影响的初步研究[J].中国康复医学杂志,2023,(3):313~318 |
| 康复训练对肝移植术后患者肺功能和运动功能影响的初步研究 点此下载全文 |
| 刘贵容 任宇基 郑海清 任芳菲 张 彤 邹云山 胡昔权 |
| 中山大学附属第三医院康复医学科，广东省广州市，510630 |
| 基金项目：国家重点研发计划项目（2018YFC2001603） |
| DOI：10.3969/j.issn.1001-1242.2023.03.005 |
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| 摘要： |
| 摘要
目的：探讨强化康复训练和常规康复训练对肝移植术后患者肺功能、运动功能、日常生活活动能力及焦虑抑郁情绪疗效的优劣。
方法：选取符合入组标准的肝移植术后患者41例，按照患者意愿分为常规康复训练组21例和强化康复训练组20例，2组均接受术后常规治疗，常规康复组在此基础上按照护士提供的《肝移植术后康复执行单》在护工监督下进行康复训练；强化康复组由物理治疗师指导监督进行强化康复训练，包括功能活动训练、有氧训练、抗阻训练、呼吸训练、日常生活活动指导与宣教等，5次/周，从患者转入普通病房的第二天开始直至出院。分别于治疗前及出院前进行肺功能指标（肺功能测试仪测定的用力肺活量（FVC）、第一秒用力呼气量（FEV1）、一秒率（FEV1/FVC）及最大自主通气量（MVV））、运动能力（Rivermead运动指数）、四肢肌力（医学研究理事会评分）、改良Barthel指数（modified Barthel index， MBI）及心理状态（医院焦虑抑郁量表）评估，并记录2组患者的术后住院天数。
结果：与治疗前相比，2组患者在治疗后肺功能（FVC、FEV1、MVV）、运动能力、四肢肌力、日常生活活动能力及焦虑抑郁均显著改善（P<0.05），而FEV1/FVC在治疗后改善不显著。2组患者在治疗前及治疗后组间比较，所有功能指标差异均无显著性意义（P>0.05），但与常规康复组相比，强化康复组治疗前后的FVC差值、MBI差值及焦虑抑郁得分差值有显著性意义（P<0.05），2组的普通病房住院时间和术后总住院时间组间比较差异均无显著性意义（P>0.05）。
结论：两种康复策略均能显著改善患者的肺功能、运动功能、日常生活活动能力及不良情绪。相较于常规康复训练，强化康复训练在改善肝移植术后患者肺功能、日常生活活动能力及焦虑抑郁情绪方面更具优势，但并未缩短术后住院时间。 |
| 关键词：康复训练 肝移植 肺功能 运动功能 |
| Effects of rehabilitation training on pulmonary function and motor function in patients after liver transplantation：a pilot study Download Fulltext |
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| The Third Affiliated Hospital， Sun Yat-sen University， Guangzhou， 510630 |
| Fund Project: |
| Abstract: |
| Abstract
Objective： To compare the effects of intensive rehabilitation training and routine rehabilitation training on lung function， motor function， ability of daily living activities and anxiety and depression after liver transplantation.
Method： Select 41 cases of liver transplantation patients who met the entry standard. According to their will， they were divided into the intensive rehabilitation training group （n=20） and routine rehabilitation training group （n=21）. Both groups received health education about rehabilitation， medications and nutrition as soon as their vital signs were stable after the operation. On this basis， the intensive rehabilitation group were supervised by physical therapists to implement personalized and intensive early rehabilitation treatment， including functional activity training， aerobic training， resistance training， breathing training， daily living activity guidance and propaganda， 5 times a week， from the second day of patients transferred to the general ward until discharge. Patients in the routine rehabilitation group received rehabilitation training under the supervision of nursing workers in accordance with the Early Rehabilitation Training Schedule for Liver transplantation Patients. Patients' functional status was evaluated on the second day after transfer to the general ward and before discharge， including： lung function （FVC， FEV1， FEV1/FVC and MVV measured by pulmonary function instrument）， motor ability（Rivermead motor index）， muscle strength of limbs （medical research council score）， ability of daily living activities （modified barthel index， MBI） and psychological status （hospital anxiety and depression scale）. The postoperative hospitalization days of the two groups of patients were recorded.
Result： Compared with before treatment， lung function （FVC， FEV1， MVV）， motor ability， muscle strength of limbs and ability of daily living activities were significantly improved in 2 groups after treatment （P<0.05），while FEV1/FVC was not significantly improved in 2 groups after treatment. There were no statistically significant differences in all functional indicators between the 2 groups before and after treatment （P>0.05）. However, when compared with the conventional rehabilitation group， the difference of FVC， the difference of modified Barthel index score and the difference of anxiety and depression score before and after treatment in the intensive rehabilitation group were statistically significant （P<0.05）. There was no significant difference between the two groups in the length of stay in the general ward and the total length of stay after surgery（P>0.05）.
Conclusion： The two rehabilitation programs after liver transplantation can significantly improve the patients' lung function， motor ability， muscle strength of limbs，the ability of daily living activities and anxiety and depression. Compared with conventional rehabilitation training， intensive rehabilitation training may have greater advantages in improving lung function， ability of daily living activities and anxiety and depression in patients after liver transplantation. Unexpectedly, the postoperative hospital stay was not shortened. |
| Keywords:rehabilitation liver transplantation pulmonary function motor function |
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