| 俞亦好,王小红,戴新建,池琼,黄茫茫.呼吸康复操在慢阻肺急性加重期无创通气患者中的应用[J].中国康复,2024,39(8):484-488 |
| 呼吸康复操在慢阻肺急性加重期无创通气患者中的应用 |
| Application of respiratory rehabilitation exercises in non-invasive ventilation patients with acute exacerbation of chronic obstructive pulmonary disease |
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| DOI：10.3870/zgkf.2024.08.008 |
| 中文关键词: 呼吸康复操 慢阻肺急性加重期 无创通气 呼吸困难 肺功能 |
| 英文关键词: breathing rehabilitation exercises acute exacerbation of chronic obstructive pulmonary disease non-invasive ventilation difficulty breathing pulmonary function |
| 基金项目:温州市科学技术局基础性医疗卫生科技项目（Y20210661） |
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| 中文摘要: |
| 目的：研究呼吸康复操在慢阻肺急性加重期无创通气患者中的应用效果。方法：选择慢阻肺急性加重期无创通气患者78例，采用随机法分为对照组和研究组，每组39例，对照组接受常规治疗和健康指导，研究组在对照组基础上增加呼吸康复操，比较2组患者干预前后的咳痰分值、慢阻肺患者自我评估测试（CAT）问卷评分、改良版英国医学研究委员会呼吸困难（mMRC）问卷评分、C-反应蛋白(CRP）、肺功能指标水平、动脉血气指标水平。结果：干预8周后，2组咳痰分值、CAT问卷和mMRC评分及CRP、二氧化碳分压（PCO2）水平较干预前均明显降低（P＜0.05，0.01），且研究组低于对照组（P＜0.05，0.01）；2组第一秒用力呼气量（FEV1）、第一秒用力呼气容积占预计值百分比（FEV1% pred）、FEV1/用力肺活量（FEV1/FVC）、最大呼气中段流量（MMEF）等肺功能指标和氧分压（PO2）水平较干预前均明显升高（P＜0.05，0.01），且研究组高于对照组（P＜0.05，0.01）。结论：呼吸康复操在慢阻肺急性加重期无创通气患者中的应用效果显著，不仅能有效改善患者呼吸、肺通气功能以及血气分期指标水平，还能减轻其机体炎症因子水平，从而能全面改善其预后。 |
| 英文摘要: |
| Objective: To explore the application effect of respiratory rehabilitation exercises on non-invasive ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods: In total, 78 patients with acute exacerbation of COPD were randomly divided into the control group （n=39）and the observation group （n=39）. The control group received anti-infection treatment, phlegm reduction, nutritional support, oxygen therapy, non-invasive ventilation, and routine intervention guidance such as maintaining respiratory tract patency, strengthening psychological intervention, and persuading smoking cessation. The observation group received respiratory rehabilitation exercises on the basis of the control group. The sputum score, CAT questionnaire score, mMRC score, and lung function index level of the two groups before and after intervention were compared. The lung function index included maximum expiratory mid segment flow (MMEF), first second forced expiratory volume (FEV1), percentage of first second forced expiratory volume to estimated value (FEV1% estimated value), FEV1/forced vital capacity (FEV1/FVC). C-reactive protein (CRP) and arterial blood gas index levels ［including partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), etc.］ were determined. Results: After 8 weeks of intervention, expectoration score and CAT questionnaire score in two groups were significantly lower than before intervention (P<0.05), and those in the observation group were lower than in the conventional group (P<0.05); mMRC score and CRP level in two groups were significantly lower than before intervention (P<0.05), and those in the observation group were lower than the conventional group (P<0.05); The levels of FEV1, FEV1% pred, FEV1/FVC, MMEF and other pulmonary function indexes in two groups were significantly higher than those before intervention (P<0.05), and those in the observation group were higher than in the conventional group (P<0.05); The levels of PO2 and PCO2 in two groups were improved as compared with those before intervention (P<0.05), and those in the observation group were superior to the conventional group (P<0.05). Conclusion: The application effect of respiratory rehabilitation exercises in patients with acute exacerbation of COPD through non-invasive ventilation is significant. It can not only effectively improve the patient’s respiratory, pulmonary ventilation function, and blood gas staging indicators, but also reduce the level of inflammatory factors in the body, thereby comprehensively improving their prognosis. |
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