目的 探讨基于肺康复的阻抗训练联合营养支持对老年慢性阻塞性肺疾病（COPD）衰弱患者肌少症及运动耐量的影响。方法 将2024年1月—2025年5月收治的80例老年COPD衰弱合并肌少症患者，分为对照组、观察组，各40例。所有患者均采取常规药物治疗，对照组予以营养支持，观察组在对照组基础上增加基于肺康复的阻抗训练。比较两组治疗前、治疗3个月后肌少症改善情况，运动耐量，肺功能指标，衰弱状态及生活质量。结果 治疗3个月后，观察组骨骼肌指数、握力、股四头肌肌厚度均较治疗前提高，且与对照组相比，观察组更高（P＜0.05）；治疗3个月后，两组6 min步行距离、日常活动代谢当量均较治疗前提高，Borg量表评分降低，且与对照组相比，观察组改善幅度更大（P＜0.05）；治疗3个月后，两组第一秒用力呼气容积（FEV1）、FEV1/用力肺活量（FVC）、最大通气量（MVV）均较治疗前改善，且与对照组相比，观察组更优（P＜0.05）；治疗3个月后，两组Fried衰弱表型评分、COPD评估测试（CAT）总分、圣乔治呼吸问卷（SGRQ）总分均较治疗前降低，且与对照组相比，观察组更低（P＜0.05）。结论 老年COPD衰弱合并肌少症患者采取基于肺康复的阻抗训练联合营养支持可改善其肌少症情况，提升运动耐量，并且提升患者肺功能水平，改善衰弱状态，提升生活质量。

       Objective To explore the effects of impedance training based on pulmonary rehabilitation combined with nutritional support on sarcopenia and exercise tolerance in elderly patients with chronic obstructive pulmonary disease（COPD）and frailty．Methods Eighty elderly patients with COPD and frailty complicated by sarcopenia，admitted from January 2024 to May 2025，were selected as the study subjects and divided into a control group and an observation group，with 40 patients in each group．All patients received conventional drug therapy．The control group received nutritional support，while the observation group received additional impedance training based on pulmonary rehabilitation on top of the matched group’s treatment．The improvement of sarcopenia，exercise tolerance，pulmonary function index，weakness status and quality of life before and 3 months after treatment were compared between the two groups．Results After 3 months of treatment，the skeletal muscle index，grip strength and quadriceps thickness of the observation group increased compared with that before treatment，and compared with the control group，the observation group was higher（P＜0.05）．After 3 months of treatment，the 6 min walking distance and daily activity metabolic equivalent of both groups increased compared with that before treatment，and the Borg Scale score decreased．Compared with the control group，the improvement of the observation group was better（P＜0.05）．After 3 months of treatment，Forced Expiratory Volume in one second（FEV1），FEV1/Forced Vital Capacity（FVC）and Maximal Voluntary Ventilation（MVV）of both groups improved compared with that before treatment，and the observation group  was better than that of the control group（P＜0.05）．After 3 months of treatment，the Fried weakness phenotype score，COPD Assessment Test（CAT）total score and St. George’s Respiratory Questionnaire（SGRQ）total score of both groups were lower than that before treatment，and the observation group  was lower than that of the control group（P＜0.05）．Conclusions Impedance training based on pulmonary rehabilitation combined with nutritional support can improve sarcopenia，enhance exercise tolerance，and improve pulmonary function levels，frailty status，and quality of life in elderly patients with COPD and frailty complicated by sarcopenia．

目的 探讨综合呼吸康复训练对老年慢性阻塞性肺疾病急性期（AECOPD）患者的临床症状、生活质量、活动能力、肺功能、肺康复依从性的影响。方法 纳入70 例AECOPD 患者,随机数字分为对照组（n=35）和干预组（n=35）,对照组在常规治疗基础上予缩唇腹式呼吸功能锻炼,干预组在常规治疗基础上进行综合呼吸康复训练,干预前后采用慢性阻塞性肺疾病评估测试（CAT）调查问卷、改良版英国医学研究委员会呼吸问卷（mMRC）、肺功能第一秒用力呼气容积（FEV1）预计值进行评估。结果 对照组呼吸康复训练前后CAT评分、mMRC量表呼吸困难评级比较差异均有统计学意义（t=16.781,t=8.103,均P<0.001）;干预组呼吸康复训练前后CAT评分、mMRC呼吸困难评级比较差异也均有统计学意义（t=24.035,t=15.938,均P<0.001）;干预组患者的CAT评分、mMRC量表呼吸困难评级较对照组下降明显。结论 综合呼吸康复训练能有效改善 AECOPD 患者临床症状、增强患者活动能力、提高生活质量、提高肺康复依从性。

Objective To investigate the effects of comprehensive respiratory rehabilitation training on clinical symptoms,quality of life,activity ability,lung function and compliance of elderly patients with acute exacerbation of obstructive pulmonary disease（AECOPD）．Methods Seventy patients with AECOPD were included and randomly divided into control group（n=35）and intervention group（n=35）．The control group was given routine treatment and respiratory muscle function exercise．The intervention group was given routine treatment and comprehensive respiratory rehabilitation training．COPD Assessment Test（CAT）,modified Medical Research Council Scale（mMRC）and FEV1 predicted value of lung function were used to evaluate before and after intervention．Results In the control group,differences of CAT score and mMRC score were significant（t=16.781,t=8.103,P<0.001）before and after respiratory rehabilitation training．In the intervention group,the CAT score before and after respiratory rehabilitation training showed a 0.01 level of significance（t=24.035,P<0.001）,and the mMRC score before and after training showed a 0.01 level of significance（t=15.938,P<0.001）．There were significant differences between control group and intervention group（P<0.01）．Compared with the control group,CAT score and mMRC score were significantly lower in the intervention group．Conclusions Comprehensive respiratory rehabilitation training can effectively improve the clinical symptoms of AECOPD patients,enhance the activity ability of patients,improve the quality of life,and improve the compliance of patients to perform pulmonary rehabilitation．

目的 调查非重症监护室护士对住院卧床老年患者肺康复的知信行现状,探讨其影响因素。方法 采用自行设计的卧床老年患者肺康复知信行现状调查问卷,对广州市第一人民医院的555 名非重症监护室护理人员进行调查。结果 共回收有效问卷513份。调查对象肺康复知信行总分为（76.01±12.27）分,知识维度、态度维度、行为维度得分分别为（14.09±3.25）、（21.89±3.38）、（40.03±9.87）分。多元回归分析显示,主要影响护士对住院老年卧床患者实施肺康复知信行的因素为护龄、是否参加过肺康复相关培训及科室是否已开展肺康复（P<0.05）。结论 非重症监护室护士对卧床老年患者肺康复的态度积极,行为良好,但知识有待提升。建议开展卧床老年人相关肺康复培训,激励护士主动学习肺康复新理念的积极性和主动性,强化理论联系临床实践,从而提高临床护理质量。

Objective To investigate the knowledge,attitude and practice of non-intensive care unit（ICU）nurses about pulmonary rehabilitation of hospitalized bedridden elderly patients,and to explore the influencing factors．Methods A self-designed questionnaire on the status of knowledge,attitude and practice about pulmonary rehabilitation of bedridden elderly patients was used to investigate 555 non-ICU nurses in our hospital．Results A total of 513 valid questionnaires were collected．The total score of pulmonary rehabilitation was（76.01±12.27）,and the scores of knowledge,attitude and practice were（14.09±3.25）,（21.89±3.38）and（40.03±9.87）,respectively．Multiple regression analysis showed that the main factors affecting nurses' knowledge,attitude and practice in implementing pulmonary rehabilitation for hospitalized elderly bedridden patients were nursing age,whether they had participated in training related to pulmonary rehabilitation and whether pulmonary rehabilitation had been carried out in the unit（P<0.05）．Conclusions Non-ICU nurses have positive attitudes and good practice toward pulmonary rehabilitation for bedridden elderly patients,but their knowledge needs to be improved．It is recommended that training on pulmonary rehabilitation for the bedridden elderly be carried out to motivate nurses to learn new concepts of pulmonary rehabilitation,strengthen the link between theory and clinical practice,and improve the quality of clinical care．