多学科呼吸康复联合无创正压通气治疗老年重度慢性阻塞性肺疾病患者
Multidisciplinary respiratory rehabilitation in combination with non-invasive positive pressure ventilation in the treatment of elderly patients with severe chronic obstructive pulmonary disease.
作者信息
Cui Limin, Liu Haixia, Sun Lei
机构信息
Limin Cui Binzhou People's Hospital, Shandong, 256610, China.
Haixia Liu Binzhou People's Hospital, Shandong, 256610, China.
出版信息
Pak J Med Sci. 2019 Mar-Apr;35(2):500-505. doi: 10.12669/pjms.35.2.459.
OBJECTIVE
To explore the effectiveness of multidisciplinary comprehensive respiratory rehabilitation in combination with non-invasive positive pressure ventilation (NIPPV) in the treatment of elderly patients with severe chronic obstructive pulmonary disease (COPD).
METHODS
Eighty-eight elderly patients with severe COPD who were admitted by the hospital between February 2016 and April 2017 were enrolled and grouped into a control group (n=29), intervention Group-A (n=30) and intervention Group-B (n=29) according to random sampling. Patients in the control group were given medicines and oxygen therapy; intervention Group-A was given NIPVV in addition to medicines and oxygen therapy; intervention Group-B was given multidisciplinary comprehensive respiratory rehabilitation in addition to the treatment as the intervention Group-A. Cardiopulmonary exercise testing, body mass index, BODE index score (airflow obstruction, dyspnea, and exercise capacity index), scoring of quality of life and arterial blood gas analysis were performed before treatment and in the 3 month after treatment.
RESULTS
The maximum exercise power (W), maximum oxygen uptake (VO), six minutes walking distance (6MWD), modified British Medical Research Council (MMRC), BODE index, score of quality of life, arterial partial pressure of carbon dioxide (PaCO) and arterial partial pressure of oxygen (PaO) of intervention Group-A and b were significantly improved after treatment (P<0.05); the differences with the control group had statistical significance (P<0.05). The improvement of 6MWD, MMRC, score of quality of life, PaO and PaCO of intervention Group-B was superior to that of intervention Group-A. (P<0.05).
CONCLUSION
Multidisciplinary comprehensive respiratory rehabilitation in combination with NIPPV can further relieve dyspnea of patients, enhance exercise tolerance and quality of life, and facilitate recovery; hence it is worth application and promotion.
目的
探讨多学科综合呼吸康复联合无创正压通气（NIPPV）治疗老年重度慢性阻塞性肺疾病（COPD）患者的效果。
方法
选取2016年2月至2017年4月期间在我院收治的88例老年重度COPD患者，采用随机抽样法将其分为对照组（n = 29）、干预A组（n = 30）和干预B组（n = 29）。对照组给予药物及氧疗；干预A组在药物及氧疗基础上给予NIPVV；干预B组在干预A组治疗基础上给予多学科综合呼吸康复。于治疗前及治疗后3个月进行心肺运动试验、体重指数、BODE指数评分（气流阻塞、呼吸困难和运动能力指数）、生活质量评分及动脉血气分析。
结果
干预A组和B组治疗后最大运动功率（W）、最大摄氧量（VO）、6分钟步行距离（6MWD）、改良英国医学研究委员会（MMRC）、BODE指数、生活质量评分、动脉血二氧化碳分压（PaCO）及动脉血氧分压（PaO）均显著改善（P < 0.05）；与对照组比较差异有统计学意义（P < 0.05）。干预B组6MWD、MMRC、生活质量评分、PaO及PaCO的改善情况优于干预A组（P < 0.05）。
结论
多学科综合呼吸康复联合NIPPV可进一步缓解患者呼吸困难，提高运动耐力和生活质量，促进康复；值得应用推广。
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