The impact of a hierarchical progressive pulmonary rehabilitation nursing program on lung function and exercise tolerance in AECOPD patients
分层递进式肺康复护理方案对AECOPD患者肺功能及运动耐力的影响

摘要

目的 旨在探究分层递进式肺康复护理在慢性阻塞性肺疾病急性加重（AECOPD）患者临床干预中的应用实效，本研究着重解析了该方案在优化患者呼吸功能状态及增强运动耐受能力方面的具体价值。方法 选取2025年2月至2026年4月间本院呼吸内科收治的50例慢阻肺急性加重期患者作为研究对象，按随机数字表法将其均分为观察组与对照组，每组25例。对照组接受常规护理，观察组则在此基础上开展分层递进式肺康复护理方案。研究对比了两组干预前后的肺功能水平、运动耐力指标及改良版英国医学研究委员会呼吸困难量表评分。结果 干预结束后，观察组患者的第一秒用力呼气容积（FEV1）%pred与FEV1/用力肺活量（FVC）指标均优于对照组，差异有统计学意义（P<0.05）；观察组在6分钟步行距离（6MWD）测试中表现出更强的运动耐力，且改良呼吸困难量表（mMRC）评分明显下降，呼吸困难症状的缓解程度均优于对照组，差异有统计学意义（P<0.05）。结论 通过分层递进模式形成的肺康复护理干预方案，可以明显改善慢性阻塞性肺疾病急性加重期患者的肺通气功能，提高患者运动耐受能力，减轻呼吸困难临床表现，具有较大的临床护理推广使用价值。

Abstract

Objective To explore the effectiveness of hierarchical progressive pulmonary rehabilitation nursing in clinical interventions for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), this study focused on analyzing the specific value of this approach in optimizing patients’ respiratory function and enhancing exercise tolerance.
Methods A total of 50 patients with AECOPD admitted to the respiratory medicine department of our hospital between February 2025 and April 2026 were selected as the study subjects. They were randomly divided into an observation group and a control group, with 25 cases in each group. The control group received routine nursing care, while the observation group received hierarchical progressive pulmonary rehabilitation nursing in addition to the routine care. The study compared the pulmonary function levels, exercise tolerance indicators, and modified Medical Research Council dyspnea scale scores between the two groups before and after the intervention.
Results After the intervention, the Forced Expiratory Volume in 1 second (FEV1) %pred and FEV1/Forced Vital Capacity (FVC) indicators in the observation group were superior to those in the control group, with statistically significant differences (P<0.05). The observation group demonstrated stronger exercise tolerance in the Six-Minute Walk Distance (6MWD) test, and the modified Medical Research Council Dyspnea Scale (mMRC) scores significantly decreased, with better alleviation of dyspnea symptoms compared to the control group, showing statistically significant differences (P<0.05).
Conclusion   The hierarchical progressive pulmonary rehabilitation nursing intervention scheme can significantly improve pulmonary ventilation function in patients with AECOPD, enhance exercise tolerance, alleviate clinical manifestations of dyspnea, and has considerable value for clinical nursing application.