Lung rehabilitation, make breathing easier!
At present, the survey shows that after receiving lung specialist treatment, the number of hospitalizations of COPD patients has decreased by 40%, the per capita medical expenditure has decreased by 60%, the survival time has increased by 3 years, the activity and work efficiency have increased by 70%, the depression and anxiety of patients have decreased by 50%, and the awareness and consciousness have increased by 80%.
Therefore, in addition to traditional drug therapy, pulmonary rehabilitation is also a major measure of COPD treatment.
1. Lung rehabilitation
Pulmonary rehabilitation, also known as respiratory rehabilitation. After a full and comprehensive assessment of the patient's physical condition, through exercise training, respiratory training, health education, nutrition intervention, psychological intervention and other intervention measures to improve the patient's physical and mental health, so that they can maintain good health habits for a long time
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2. Treatment object of pulmonary rehabilitation
Some people will think that pulmonary rehabilitation is mainly used for patients in the respiratory department, but at present, the scope of pulmonary rehabilitation has been expanding and is no longer limited to patients in the respiratory department. Pulmonary rehabilitation may be required as long as there is dyspnea, reduced exercise tolerance, and disease affecting respiratory function.
For example, patients with gas incision intubation, in the long-term intubation process, there are a series of problems such as excessive sputum, lung infection, and reduced cough ability.
At this time, it is necessary to carry out pulmonary rehabilitation, promote sputum discharge, improve lung infection, adjust respiratory pattern, improve respiratory frequency, reinflate collapsed lung tissue, enhance respiratory muscle strength, improve cough ability, reduce the use of antibiotics, help extubation, and shorten the length of hospital stay of patients. This is one of the advantages of pulmonary rehabilitation.
3、Treatment methods of pulmonary rehabilitation
"Exercise training" is an important part of lung rehabilitation.
In the pulmonary rehabilitation guidelines, it is recommended to include lower limb exercise as a mandatory requirement of exercise training. The number of exercises is 3-5 times a week, 30 minutes to an hour at a time, gradually exercise.
Lower extremity exercise includes walking, running, stair climbing, treadmill exercise, power cycling and so on. Upper limb exercise mainly includes: upper limb power meter method, weight lifting, throwing and so on. The heart rate during exercise is between 170 and age, such as 60 years old, and the heartbeat is 170 to 60=110 beats per minute.
In addition, pulmonary rehabilitation includes "oxygen therapy".
However, although oxygen therapy is also a commonly used treatment measure, seemingly simple, in fact, there are many concerns. Improper oxygen therapy can lead to many adverse consequences, or do not achieve the desired therapeutic effect, or cause oxygen poisoning, increase carbon dioxide retention, etc
The purpose of oxygen therapy is to correct metabolic disorders and physiological disorders caused by hypoxemia. Generally, PaO250≥ 60 mmHg or SaO2≥ 90% can be achieved after oxygen inhalation. For patients with chronic hypercapnia, oxygenation targets can be appropriately reduced to reach PaO2≥ 55 mmHg or SaO2≥ 85%.
In patients with chronic obstructive pulmonary disease (COPD) or type II respiratory failure, CO2 retention is associated with high concentration of oxygen inhalation, which leads to decreased alveolar ventilation and aggravates CO2 retention. Therefore, patients with chronic obstructive pulmonary disease accompanied by CO2 retention, oxygen therapy, a day of oxygen inhalation time > 15H, each oxygen inhalation oxygen flow 1 ~ 2L, oxygen concentration ≤35%, preferably ≤30%, while paying close attention to observation.
In addition, non-invasive ventilator assisted ventilation treatment, nutritional support treatment, psychological counseling and other pulmonary rehabilitation treatment methods.
However, the most important thing for pulmonary rehabilitation treatment must be carried out on the basis of adequate and reasonable drug therapy. And need to be treated under the professional guidance of a doctor to avoid other adverse effects.
Case sharing:
In March 2019, 67-year-old old Bo came to the hospital for treatment due to chronic obstructive pulmonary disease. His wheeting sound was obvious, and CT examination indicated emphysema and large volume of shadow in the right lower lung. Pulmonary function examination indicated extremely severe obstructive ventilation dysfunction, and the diagnosis was "acute exacerbation of chronic obstructive pulmonary disease, right pneumonia, and coronary heart disease".
After fully understanding the physical condition of the old man, the respiratory physician of the hospital chose drug treatment, and after the symptoms of the old man were significantly relieved, the respiratory rehabilitation treatment was added. After 3 months, the old man's exercise ability improved, the symptoms were significantly relieved, the quality of life was improved, and the number of acute exacerbations was also reduced.
In general, pulmonary rehabilitation is not only a means of treatment, but also a proactive prevention of lung disease, aiming to improve patients' respiratory function, reduce disease symptoms, improve daily activity endurance, and promote the stabilization of the disease
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