| ObjectiveChronic ObstructivePulmonary Disease(COPD)is a common chronic respiratory disease,due to chronic onset,recurrent,high mortality,high disability rate,social and economic burden.COPD will be fifth worldwide burden of disease in In the next 10 years.Ventilation function and diffusion dysfunction in patients with COPD could lead to reducing oxygen uptake in skeletal muscle with myasthenia;oxygen uptake decreased while exercise increased oxygen consumption and increase the patient's dyspnea,which lead to exercise capacity further decline.But reducing exercise may increase lung function,accelerating the degradation of muscle strength.At the same time,it increased the patient's anxiety and depression to forming a vicious spiral.So it become a problem worthy discussing how to improve exercise capacity and quality of life of patients with symptoms of pulmonary rehabilitation in the patients.The concept and content of pulmonary rehabilitation have been constantly enriched and updated in the past 20 years as an intervention.Pulmonary rehabilitation was formally put forward in the early 2001,Which has gradually become the ATS developing with pulmonary rehabilitation work and the spread of pulmonary rehabilitation for the outpatient pulmonary rehabilitation and development of hospitalized patients.The American Thoracic Society(ATS)and the European Respiratory Association(ERS)define the concept and purpose of lung rehabilitation in 2006,On the basis of evidence-based medicine,it combined with multidisciplinary,provide individualized comprehensive intervention program for symptomatic chronic lung damage patients.The purpose of lung rehabilitation is to stabilize or reverse the clinical manifestations of diseases,to alleviate symptoms,optimize functional status,improve daily and social activities,and reduce medical expenses.This requires the rehabilitation of the lung as an intervention program,the real implementation of the need for a large number of manpower and material input as a guarantee,but in the economic low-level in the region can't be used as a routine promotion.The hotspot and difficult problem is how to arrange the stable COPD patients with pulmonary rehabilitation treatment,improve compliance,scientific arranging of exercise.It has been shown that through special home health care workers can improve the pulmonary rehabilitation effect on patients with COPD guidance Family Ward.It need more security,practical,economic,convenient technology to help families in the ward of COPD patients with pulmonary rehabilitation work for the current shortage of medical resources and high cost of door-to-door service factors.Remote medical technology(Cloud-ICU)has the advantages of convenient,fast,cheap and other advantages,so the pulmonary rehabilitation settings and transfer method has great potential to adapt to the needs of different groups of people,which can explore the application of remote medical treatment for pulmonary rehabilitation in patients with COPD.MethodThe-self-controlled trial was conducted to compare the effects of pulmonary rehabilitation before and after receiving telemedicine support.This study was for 40 stable COPD patients with respiratory failure requiring oxygen therapy and continuous(intermittent)respiratory support therapy after treating the stable COPD patients who were treated turn to a home ward.The patients were divided into intervention group 20 cases with regular pulmonary rehabilitation training and health education guidance.The control group(20 cases)only provided related content consultation and health education guidance.Evaluation tools:1)we used the Chinese Evaluation tools of western scholars Jones' COPD assessment test developed in 2009(COPD Asessment Test,CAT).First,we conducted the statistics on patients with remote medical technology guidance again after 12W experiment in general and CAT score.2):6 minutes walk test(6MWT):we recorded interference group and control group in the 6 minute walk test at the beginning of the study and after 12 weeks with the experiment.We estimated by statistical analysis of patients pulmonary rehabilitation with 6MWT changes COPD telemedicine technology before and after treatment.ResultResults:through telemedicine intervention in patients before and after pulmonary rehabilitation.1)The total score of CATand symptoms improved,exercise capacity improved is increased statistically significant compare without receiving telemedicine technology support theas(P<0.05).While the patients in the psychological improvement including sleep,energy and mood in patients with CAT scores were not significantly change before receiving(P>0.05).2)6 minute walk test(6MWT),The intervention group improved by 61 meters before the telemedicine treatment.The two groups received the guidance of telemedicine technology before and after pulmonary rehabilitation treatment,had significant difference(P<0.05),the steering group was significantly better than the control group.3)In the study group,20 patients completed the 12 week rehabilitation training,the completion rate was 100%.In the control group,only 1 of the 20 patients completed the 12 week rehabilitation training,the completion rate was 5%.The completion rate was significant(p=0.000).Conclusion1,The telemedicine technology has a significant effect on the improvement of lung rehabilitation in COPD patients in the improvement of symptoms and exercise ability,2,The effects of pulmonary rehabilitation with remote medical treatment technology is not obvious on improving the psychological aspect,for patients with chronic obstructive pulmonary disease including mood,sleep and energy.3,The remote medical technology has obvious effect on patients with chronic obstructive pulmonary disease secondary to improve exercise ability level.4.The telemedicine can improve the management of lung rehabilitation in patients with COPD,and improve the compliance of patients with lung rehabilitation. |
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