邓淑坤,袁鹏,钱际银,等.基于ICF核心组合的康复治疗对肺移植术后患者功能结局的影响[J].中华物理医学与康复杂志,2026,48(5):437-443
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| 基于ICF核心组合的康复治疗对肺移植术后患者功能结局的影响 |
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| DOI：10.3760/cma.j.cn421666-20250320-00242 |
| 中文关键词: 国际功能、残疾和健康分类 肺移植 康复治疗 健康状况调查简表 |
| 英文关键词: International Classification of Functioning, Disability and Health Lung transplantation Pulmonary rehabilitation Short Form Health Survey |
| 基金项目:无锡市人民医院“雁阵人才”青年拔尖人才项目（2025-YZ-QNBJ-DSK-2025）；2020太湖人才计划高端人才项目(2020THRC-GD-8)；无锡市科协软课题（KX-24-B27） |
| 作者 | 单位 | | 邓淑坤 | 南京医科大学附属无锡人民医院康复医学科,无锡 214023
南京医科大学附属无锡医学中心康复医学科,无锡 214023
无锡市人民医院康复医学科,无锡 214023 | | 袁鹏 | 南京医科大学附属无锡人民医院康复医学科,无锡 214023
南京医科大学附属无锡医学中心康复医学科,无锡 214023
无锡市人民医院康复医学科,无锡 214023 | | 钱际银 | 南京医科大学附属无锡人民医院急诊医学科,无锡 214023
南京医科大学附属无锡医学中心急诊医学科,无锡 214023
无锡市人民医院急诊医学科,无锡 214023 | | 梅盛瑞 | 南京医科大学附属无锡人民医院康复医学科,无锡 214023
南京医科大学附属无锡医学中心康复医学科,无锡 214023
无锡市人民医院康复医学科,无锡 214023 | | 冯梦月 | 南京医科大学附属无锡人民医院康复医学科,无锡 214023
南京医科大学附属无锡医学中心康复医学科,无锡 214023
无锡市人民医院康复医学科,无锡 214023 | | 张诗婷 | 南京医科大学附属无锡人民医院康复医学科,无锡 214023
南京医科大学附属无锡医学中心康复医学科,无锡 214023
无锡市人民医院康复医学科,无锡 214023 | | 吴波 | 南京医科大学附属无锡人民医院肺移植中心,无锡 214023
南京医科大学附属无锡医学中心肺移植中心,无锡 214023
无锡市人民医院肺移植中心,无锡 214023 |
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| 中文摘要: |
| 目的 观察基于ICF核心组合的康复治疗对肺移植术后患者肺功能、膈肌功能、运动功能、日常生活活动能力以及生活质量的影响。 方法 募集肺移植术后患者49例，按随机数字表法分为ICF组25例和对照组24例。2组患者均接受肺移植术后常规治疗和常规康复治疗，ICF组患者在此基础上接受基于ICF核心组合的康复治疗。ICF组先采用ICF核心组合进行身体结构、功能和活动参与评估，然后根据评定结果制定康复计划并治疗，基于ICF核心组合的康复治疗每日1次，每次30～90 min，每周治疗5 d，连续治疗12周。对照组采用常规康复模式对患者进行评估和治疗。于治疗前和治疗12周后（治疗后）采用肺功能检查、膈肌B超、6 min步行距离（6MWD）、改良Barthel指数（MBI）、健康状况调查简表（SF-36）分别评估2组患者的肺功能、膈肌功能、运动能力、日常生活活动能力和生活质量，并进行统计学分析。 结果 治疗12周后，对照组的第一秒用力呼气容积（FEV1）、第一秒用力呼气容积占预计值的百分比(FEV1%)、用力肺活量(FVC)、用力肺活量占预计值的百分比(FVC%)、呼气峰值流量(PEF)、6MWD、MBI、SF-36评分均显著优于组内治疗前（P<0.05）。治疗12周后，ICF组的FEV1、FEV1%、FVC、FVC%、PEF、6MWD、左侧膈肌活动度、右侧膈肌活动度、左侧膈肌厚度、右侧膈肌厚度与组内治疗前和对照组治疗后比较，差异均有统计学意义(P<0.05)。治疗12周后，ICF组的MBI和SF-36评分分别为（92.36±2.04）分和（591.25±118.19）分，均显著优于组内治疗前和对照组治疗后，差异均有统计学意义(P<0.05)。 结论 基于ICF核心组合的康复治疗可显著改善肺移植术后患者的肺功能、膈肌功能、运动功能、日常生活活动能力和生活质量。 |
| 英文摘要: |
| Objective To evaluate the effectiveness of a rehabilitation program based on the International Classification of Functioning, Disability and Health (ICF) core set in improving the pulmonary and diaphragm functioning and motor capacity of lung transplant recipients, as well as their ability in the activities of daily living (ADL) and life quality. Methods Forty-nine lung transplant recipients were randomly assigned to either an ICF group (n=25) or a control group (n=24). Both groups received standard post-transplant medical care and conventional rehabilitation. The ICF group additionally underwent a tailored rehabilitation program guided by the ICF core set. Body structure, functional ability and activity and participation levels were assessed to form individualized treatment plans. This ICF-based intervention was delivered in 30-90-minute daily sessions, 5 days per week for 12 consecutive weeks. The control group received only conventional rehabilitation. The main outcome measures were pulmonary function tests, diaphragm ultrasound scans, 6-minute walk distance (6MWD), and scores on the modified Barthel Index (MBI) and the 36-Item Short Form Health Survey (SF-36) instrument. These were assessed at baseline and after the 12 weeks of treatment. Results After 12 weeks, both groups showed significant improvements from baseline in their average forced expiratory volume in one second (FEV1), FEV1% predicted, forced vital capacity (FVC), FVC% predicted, peak expiratory flow (PEF), 6MWDs, MBI scores, and SF-36 scores. However, the ICF group demonstrated significantly greater improvements compared to the control group in all of these outcomes, as well as in left and right diaphragm excursion and thickness. The average post-treatment MBI score in the ICF group was 92.36±2.04, and the average SF-36 score was 591.25±118.19. Both were significantly superior to the baseline values and to the post-treatment averages of the control group. Conclusions A rehabilitation program based on the ICF core set is more effective than conventional rehabilitation in improving pulmonary and diaphragm functioning, exercise capacity, ADL ability, and quality of life after a lung transplant. |
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