无创正压通气辅助踏车运动在稳定期重度慢性阻塞性肺疾病患者的实施与疗效观察

发布时间：2018-04-23 18:58

  本文选题：慢性阻塞性肺疾病 + 肺康复　； 参考：《中国呼吸与危重监护杂志》2017年05期

【摘要】：目的探讨无创正压通气(NIPPV)辅助踏车运动对稳定期重度慢性阻塞性肺疾病(简称慢阻肺)患者呼吸困难及运动耐力等的影响。方法研究选取2015年8月至2016年1月于我院呼吸与危重症医学科肺康复单元住院的20例稳定期重度慢阻肺患者。患者进行8周的NIPPV辅助踏车运动,通过自身对照方法,测定治疗前及治疗8周后12分钟步行距离、Borg呼吸困难指数、平均肺动脉压(mPAP)、日间动脉血氧分压(PaO_2)及二氧化碳分压(PaCO_2)值,治疗前后1年内慢阻肺急性加重次数,并观察治疗过程中的不良反应及依从性。结果治疗后12分钟步行距离[(810±20)m比(680±15)m]、Borg呼吸困难指数[(2.4±0.1)分比(4.4±0.3)分]、mPAP[(34.4±2.7)mm Hg比(43.5±3.8)mm Hg]、PaCO_2[(49.8±4.9)mm Hg比(64.3±5.2)mm Hg]、PaO_2[(64.4±4.1)mm Hg比(52.3±3.9)mm Hg]均较治疗前显著改善,治疗后1年内慢阻肺急性加重次数也较治疗前显著减少[(2.1±0.7)次比(4.3±2.1)次],差异均有统计学意义(P0.01)。治疗不良反应为口咽干燥2例、胃胀气8例,均可以耐受。结论 NIPPV辅助踏车运动可提高稳定期重度慢阻肺患者的运动耐力,改善呼吸困难,提高氧合并降低mPAP,减少1年内慢阻肺急性加重次数。
[Abstract]:Objective to investigate the effects of NIPPV-assisted treadmill exercise on dyspnea and exercise endurance in stable patients with severe chronic obstructive pulmonary disease (COPD). Methods from August 2015 to January 2016, 20 patients with chronic obstructive pulmonary disease (COPD) who were hospitalized in lung rehabilitation unit of respiratory and critical care department in our hospital from August 2015 to January 2016 were studied. The patients were treated with NIPPV assisted treadmill exercise for 8 weeks. Before and after 8 weeks of treatment, the walking distance and dyspnea index (Borg), mean pulmonary artery pressure (MPAP), PaO2 (PaO2) and Paco _ 2 (carbon dioxide partial pressure) were measured before treatment and 8 weeks after treatment. The number of acute exacerbations of COPD within 1 year before and after treatment and the adverse reactions and compliance during treatment were observed. Results after 12 minutes of treatment, the walking distance [810 卤20m vs 680 卤15m] Borg dyspnea index (2.4 卤0.1) score vs 4.4 卤0.3 score] Paco _ 2 [49.8 卤4.9)mm Hg vs 64.3 卤5.2)mm Hg] Paco _ 2 [64.4 卤4.1)mm Hg vs 52.3 卤3.9)mm Hg] were significantly improved. The number of acute exacerbations of COPD within 1 year after treatment was significantly lower than that before treatment [2.1 卤0.7 times vs 4.3 卤2.1 times], and the difference was statistically significant (P 0.01). The adverse reactions were oropharyngeal dryness in 2 cases and flatulence in 8 cases. Conclusion NIPPV assisted treadmill exercise can improve the exercise endurance, improve dyspnea, increase oxygen and reduce the number of acute exacerbations of COPD in one year.
【作者单位】： 湖南医药学院第一附属医院呼吸与危重症医学科;
【基金】：湖南省卫计委科研立项项目(B2017072)
【分类号】：R563.9
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本文编号：1793197