Clinical Efficacy And Safety Of Pulmonary Rehabilitation In Elderly COPD Patients With Long-Term Home Oxygen Therapy

Objective:Explore the pulmonary rehabilitation program suitable for elderly COPD patients with long-term home oxygen therapy,and observe the clinical efficacy and safety of the program.Methods:A total of 60 elderly patients with stable COPD who were successfully discharged from the First Hospital of Shanxi Medical University from November 2021 to October 2022 were included.The patients were divided into 30 patients in the pulmonary rehabilitation group and the control group according to random number method.Patients in the pulmonary rehabilitation group underwent a 12-week pulmonary rehabilitation training,Patients in the control group conducted pulmonary rehabilitation,health education and nutrition education.Comparing the general patients data between the two groups,the lung function（FEV₁,FVC,FEV₁/FVC and FEV₁%pred）,blood gas analysis（PaO₂,Pa CO₂,SaO₂）,6MWD,grip strength,5R-STST,m MRC,CAT,BBS and CCT before and after the intervention.Evaluating the safety and compliance of the training process.Results:1.There was 29 people in the pulmonary rehabilitation group and 28 people in the control group completed this study.There was no significant difference between the general data in the two groups（P>0.05）.After the intervention in the pulmonary rehabilitation group,FEV₁/FVC,PaO₂,PaCO₂,SaO₂,6MWD,grip strength,5R-STST,CAT,BBS and CCT all improved than before（P<0.05）,there was no difference in the control group（P>0.05）;Comparison between the two groups after the intervention,6MWD,CAT and CCT improved significantly compared with the control group（P<0.05）,there was no difference in the remaining indicators between the two groups（P>0.05）.2.Correlation analysis showed that the change in 6MWD was more strongly associated with changes in CAT,SaO₂,PaO₂and 5R-STST（CAT:r=-0.764,SaO₂:r=0.748,PaO₂:r=0.725,5R-STST:r=-0.653,P<0.001）.The change in CAT was more strongly correlated with changes in 6MWD and SaO₂（6MWD:r=-0.764,SaO₂:r=-0.666,P<0.001）.The change in CCT was more strongly correlated with changes in SaO₂and5R-STST（SaO₂:r=0.512,5R-STST:r=-0.544,P<0.05）.3.No training-related adverse effects occurred during the study.The overall completion rate was higher,and the number of patients in the pulmonary rehabilitation group was higher than the control group（P<0.05）,indicating better safety and compliance.Conclusion:The 12-week pulmonary rehabilitation is effective for elderly COPD patients with long-term home oxygen therapy,helping to improve their respiratory function,systemic symptoms,exercise endurance,muscle strength,balance function.Under the premise of simplicity and ease of implementation,this set of pulmonary rehabilitation program can enable patients to achieve the training goals and improve clinical symptoms,and has good safety and compliance,which is worthy of promotion and application.