中华保健医学杂志

目的 观察严重低氧血症长期氧疗的慢性阻塞性肺疾病患者实施肺康复的效果及安全性。方法 选取2022年1月～2025年2月在承德医学院附属医院就诊的长期氧疗稳定期的慢性阻塞性肺疾病患者88例，随机数表法分为两组，各44例。对照组规范用药、规范氧疗；肺康复组采用12周肺康复方案。比较两组患者基线期、干预12周后肺功能和血气指标；采用6 min步行距离(6MWD)评估运动能力；采用慢性阻塞性肺疾病CAT评分评估日常生活质量；记录患者不良事件发生情况。结果 干预前两组指标差异无统计学意义(P> 0.05)。干预12周后，肺康复组第1秒用力呼气容积(FEV₁)、第1秒呼气容积/用力肺活量比值(FEV₁/FVC)、FEV₁占预计值的百分比(FEV₁%pred)、动脉血氧分压(PaO₂)均高于对照组，动脉血二氧化碳分压(PaCO₂)略低于对照组，但两组差异无统计学意义(P> 0.05)。12周后，肺康复组6MWD高于对照组，CAT评分低于对照组，差异有统计学意义(t=3.472、3.241,P<0.05)。肺康复组训练时未出现跌倒、晕厥事件，12周内未发生心脑血管意外。结论 对于长期氧疗的慢性阻塞性肺疾病患者，进行肺康复训练可提高患者运动耐力，改善生活质量，且安全性较好。

Objective To observe the efficacy and safety of pulmonary rehabilitation in chronic obstructive pulmonary disease(COPD)patients with severe hypoxemia receiving long-term oxygen therapy(LTOT). Methods 88 stable COPD patients on LTOT were randomly divided into two groups. The control group received standard care without pulmonary rehabilitation, while the rehabilitation group underwent a 12-week pulmonary rehabilitation program. Lung function, blood gas parameters, 6-minute walk distance(6MWD)results, and COPD Assessment Test(CAT)scores were compared at baseline and after 12 weeks. Adverse events were recorded. Results No significant differences existed between groups at baseline. After 12 weeks, the rehabilitation group showed higher FEV₁,FEV₁/FVC,FEV₁% predicted, and PaO₂ levels compared with the control group, with slightly lower PaCO₂(statistically non-significant). After 12 weeks, the 6MWD in the pulmonary rehabilitation group was higher than the control group's(t=3.472,P=0.001). The CAT score in the pulmonary rehabilitation group was lower than the control group's(t=3.241,P=0.002). No falls, syncope, or cardio/cerebrovascular events occurred during the study. Conclusion Pulmonary rehabilitation improves exercise tolerance and quality of life and has good safety profile in LTOT-dependent COPD patients.