Cirić Zorica, Stanković Ivana, Rancić Milan, Pejcić Tatjana, Radović Milan
Klinicki centar, Klinika za plućne bolesti i tuberkulozu, Nis, Srbija.
Vojnosanit Pregl. 2008 Jul;65(7):533-8. doi: 10.2298/vsp0807533c.
BACKGROUND/AIM: Chronic obstructive pulmonary disease (COPD) irreversibly damages pulmonary function leading to disorder of arterial bloodgases, arterialpartial prescure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2), appearance of dyspnea, and decrease of physical condition. The aim of this study was to establish if medical treatment and respiratory rehabilitation in COPD used simultaneously lead to the greater improvement of PaO2, PaCO2 and physical condition and decreaseing dyspnea than medical treatment alone.
A total of 60 patients divided into three groups according to the severity of obstruction (mild--I, severe--II, very severe--III) weretested. Each group had the two subgroups of patients--first one with those treated both with medical treatment and respiratory rehabilitation (A) and the second one with the patients treated only with medical treatment (B). The treatment took 21 days. The measurements of PaO2 and PaCO2) intensity of dyspnea at rest and exercise (10--point Borg Category Scale), and physical capacity (Six-Minute Walk Test--6MWT) were done on the first and on the last day of testing.
The results showed that all of the patients who were treated with the combination of medical treatment and respiratory rehabilitation had significantly higher increase in the values of PaO2 (I--p < 0.01; II--p < 0.05; III--p < 0.01), score of Borg's scale (I--p < 0.05, p < 0.001; II--p < 0.05, p < 0.001; III--p < 0.001, p < 0.001) and 6MWT (I--p < 0.001; II--p < 0.001; III--p < 0.001), and that statistically significant increase of the values of PaCO2 (p < 0.05) had only the patients with very severe COPD treated with the combination of drugs and respiratory rehabilitation.
Based on the obtained results we conclude that using respiratory rehabilitation in combination with pharmacological treatment of COPD gives statistically higher improvement of values of PaO2 and PaCO2, and physical condition, and also leads to decrease of intensity of dyspnea than using just drug therapy.
背景/目的:慢性阻塞性肺疾病(COPD)会不可逆转地损害肺功能,导致动脉血气紊乱、动脉血氧分压(PaO2)和动脉血二氧化碳分压(PaCO2)异常,出现呼吸困难,并使身体状况下降。本研究的目的是确定COPD患者同时进行药物治疗和呼吸康复是否比单纯药物治疗能更有效地改善PaO2、PaCO2和身体状况,并减轻呼吸困难。
根据阻塞严重程度将60例患者分为三组(轻度—I组、重度—II组、极重度—III组)进行测试。每组患者又分为两个亚组——第一个亚组患者同时接受药物治疗和呼吸康复(A组),第二个亚组患者仅接受药物治疗(B组)。治疗为期21天。在测试的第一天和最后一天测量PaO2和PaCO2、静息和运动时的呼吸困难强度(10分制Borg量表)以及身体能力(六分钟步行试验—6MWT)。
结果显示,所有接受药物治疗和呼吸康复联合治疗的患者,其PaO2值(I组—p<0.01;II组— p<0.05;III组—p<0.01)、Borg量表评分(I组—p<0.05,p<0.001;II组—p<0.05,p<0.001;III组—p<0.001,p<0.001)和6MWT(I组—p<0.001;II组—p<0.001;III组—p<0.001)的升高均有显著统计学意义,且只有极重度COPD患者在接受药物和呼吸康复联合治疗后,PaCO2值有显著统计学意义的升高(p<0.05)。
根据所得结果,我们得出结论,与单纯药物治疗相比,COPD患者联合使用呼吸康复和药物治疗在统计学上能更显著地改善PaO2和PaCO2值以及身体状况,还能减轻呼吸困难的强度。