摘要
目的探讨呼吸功能锻炼联合家庭无创呼吸机治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者的临床疗效,为COPD合并Ⅱ型呼吸衰竭患者的家庭治疗提供参考。方法将54例COPD合并Ⅱ型呼吸衰竭患者随机分为常规组和强化组,2组患者均采用家庭无创正压机械通气治疗,另外强化组每日行呼吸功能锻炼。定期随访1年,观察患者血气指标、肺功能、生命体征变化、再住院率及患者预后情况。结果 1年后强化组患者6分钟步行距离(6MWD)变化值(73.3 m)大于最小临床显著差异值(54 m),强化组MRC评分及CAT评分明显改善(P<0.01);2组患者1 s用力呼气容积占预计值百分比(FEV1)较治疗前均明显改善(P<0.05);2组患者血气指标、再住院次数均较治疗前明显好转。结论对于合并高碳酸血症的重度、极重度COPD患者,长期家庭无创正压通气治疗对改善二氧化碳潴留、减少住院次数有明显作用,联合呼吸功能锻炼能显著改善患者症状和运动耐力。
Objective To observe the clinical efficacy of household noninvasive ventilator combined with the respiratory function exercise on chronic obstructive pulmonary disease （COPD） with type II respiratory failure patients. Methods A total of 54 COPD with type II respiratory failure patients were randomly divided into conventional treatment group and strengthen treatment group. Two groups both received home noninvasive positive pressure mechanical ventilation therapy, while the strengthen group had respiratory function exercise every day. After 1 year follow-up visit, modified British Medical Reseach Council （mMRC） and COPD Assessment Test （CAT） were used to evaluate patients＂ symptoms, 6 rain walk distance（6MWD） to evaluate patients exercise endurance. Blood gas index, pulmonary function, vital signs change, rehospitalization rate and patients＂ prognosis were observed at the same time. Results The changed value of 6MWD in strengthen group （73.3 m） is greater than the minimum clinical significant difference value （54 m）, and MRC score and CAT score in strengthen group were also improved significantly compared with before treatment （P〈0.01）. FEV1% , blood gas index and hospital admission again were obviously improved compared with before treatment in both two groups （ P〈0.05 ）. Conclusion For the severe and very severe COPD patients with hypercapnia, long-term home noninvasive positive pressure ventilation therapy can reduce the carbon dioxide retention and hospitalization frequency. Respiratory function exercise combination with long-term home noninvasive positive pressure ventilation therapy can significantly improve exercise endurance and quality of life.
出处
《解放军预防医学杂志》
CAS
2016年第3期320-322,共3页
Journal of Preventive Medicine of Chinese People's Liberation Army
关键词
慢性阻塞性肺疾病
家庭机械通气
呼吸功能锻炼
COPD
noninvasive positive-pressure ventilation
respiratory function exercise
