以世界卫生组织国际分类家族框架为基础开展慢性阻塞性肺疾病康复诊疗OA
Rehabilitation management for chronic obstructive pulmonary disease based on the World Health Organization Family of International Classifications framework
传统慢性阻塞性肺疾病(以下简称慢阻肺病)诊疗模式主要聚焦于生理指标和急性加重管理,忽视了功能、活动参与及生活质量等核心问题,而世界卫生组织国际分类家族(WHO-FICs)框架为实现全面、规范的康复诊疗提供了系统化的解决方案.基于国际疾病分类(ICD)-11,通过后组配编码可精确记录慢阻肺病的疾病诊断、严重程度及功能状态.以《国际功能、残疾和健康分类》(ICF)为导向,整合身体功能、活动、参与、环境因素及个人因素五大领域,构建生物-心理-社会模式的康复诊疗体系,并通过对评估工具与ICF条目的精准匹配指导个体化康复方案制定.阻塞性肺疾病ICF核心分类组合可作为慢阻肺病功能评估的标准化工具,在临床实践及研究中具有较好的信度和效度;《国际健康干预分类》(ICHI)的三维结构(目标-行动-手段)为康复干预行为的标准化记录提供了编码体系.WHO康复干预包则有机整合ICD、ICF与ICHI,针对慢阻肺病患者的核心健康问题提供基于循证的具体干预建议.基于WHO-FICs框架开展慢阻肺病康复诊疗,有助于促进诊疗行为的规范化、标准化,提升康复效果和患者生活质量,推动不同地区、不同医疗机构间康复服务的同质化与公平性,但该体系的构建与应用仍需通过科研与政策研究不断完善.
Traditional chronic obstructive pulmonary diseas(COPD)management models primarily focused on physiological indicators and acute exacerbation control,often neglecting core issues such as functional status,activity participation,and quality of life.World Health Organization Family of International Classifications(WHO-FICs)framework provides a systematic solution for achieving comprehensive and standardized rehabilitation management.Based on the International Classification of Diseases(ICD-11),post-coordination coding enables precise documentation of the diagnosis,severity,and functional status of chronic obstructive pulmonary disease(COPD).Guided by the International Classification of Functioning,Disability and Health(ICF),a bio-psycho-social rehabilitation system is constructed by integrating the five domains of body functions,activity and participation,environmental factors,and personal factors.Individualized rehabilitation plans are developed through precise mapping of assessment tools to ICF categories.The ICF Core Set for Obstructive Pulmonary Diseases serves as a standardized tool for functional assessment in COPD,demonstrating good reliability and validity in both clinical practice and research.The three-dimensional structure of the International Classification of Health Interventions(ICHI)—target,action,and means-provides a coding system for standardized recording of rehabilitation interventions.The WHO Package of Interventions for Rehabilitation integrates ICD,ICF,and ICHI to offer specific evidence-based intervention recommendations targeting core health problems in patients with COPD.Implementing COPD rehabilitation management based on the WHO-FICs framework promotes the standardization and normalization of clinical practices,enhances rehabilitation outcomes and patients' quality of life,and advances the homogenization and equity of rehabilitation services across different regions and healthcare institutions.However,scientific researches and policy researches are needed to further refine the construction and application of this system.
刘小燮;周谋望
北京大学第三医院康复医学科,北京 100191北京大学第三医院康复医学科,北京 100191
医药卫生
慢性阻塞性肺疾病呼吸康复世界卫生组织国际分类家族国际功能、残疾和健康分类
chronic obstructive pulmonary diseasepulmonary rehabilitationWorld Health Organization family of International ClassificationsInternational Classification of Functioning,Disability and Health
《中国实用内科杂志》 2026 (6)
455-461,7
中国科学技术协会青年人才托举工程(YESS20180055)
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