Elmorshidy Basma Elsaeed Saad, Elkholy Mohamed Gamal Amer, Elsaadany Hanan Mohamed, Mansour Youssef Mohamed, Sharshar Ragia Samir, Bahr Hoda Mokhtar
Chest Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Physical Medicine and Rehabilitation Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Can J Respir Ther. 2023 Jan 20;59:45-51. doi: 10.29390/cjrt-2022-051. eCollection 2023.
Pulmonary rehabilitation (PR) is crucial in managing chronic obstructive pulmonary disease (COPD) and enhancing functional capacity and health status. Oxygen therapy and noninvasive ventilation (NIV) may be needed to be incorporated into rehabilitation to augment the effectiveness of physical training.
To compare and assess the impact of the PR programme alone and with augmentation with O or NIV on COPD patients.
Seventy-five COPD patients were equally divided into three groups: group 1 patients performed 8 week-PR programme only. Group 2 performed the PR programme while receiving O. Group 3 completed the PR programme plus NIV. Modified Borg scale, VO max, modified Medical Research Council Dyspnea Scale, 6-minute walk test, COPD assessment test score, spirometric measures and arterial blood gases were assessed before and after the programme.
The outcome measurements showed meaningful improvement compared with the baseline in the three studied groups. However, VO max in group 3 showed higher significant improvement than both groups 1 and 2. Regarding 6-minute walk test, groups 2 and 3 had a higher significant improvement than group 1. COPD assessment test score in group 3 showed higher significant improvement than groups 1 and 2. Arterial blood gases in groups 2 and 3 showed significant increase in partial pressure of arterial oxygen and arterial oxygen saturation, but group 3 only had a significant decrease in PaCO.
O supplementation and NIV help severe to very severe COPD patients to perform higher exercise intensity, so they augment the benefits of PR.
肺康复（PR）对于慢性阻塞性肺疾病（COPD）的管理以及提高功能能力和健康状况至关重要。可能需要将氧疗和无创通气（NIV）纳入康复治疗，以增强体育锻炼的效果。
比较和评估单纯PR方案以及联合氧疗或无创通气增强方案对COPD患者的影响。
75例COPD患者平均分为三组：第1组患者仅进行为期8周的PR方案。第2组在接受氧疗的同时进行PR方案。第3组完成PR方案加无创通气。在方案前后评估改良Borg量表、最大摄氧量（VO₂max）、改良医学研究委员会呼吸困难量表、6分钟步行试验、COPD评估测试评分、肺量计测量值和动脉血气。
与基线相比，三个研究组的结果测量均显示出有意义的改善。然而，第3组的VO₂max改善程度显著高于第1组和第2组。关于6分钟步行试验，第2组和第3组的改善程度显著高于第1组。第3组的COPD评估测试评分改善程度显著高于第1组和第2组。第2组和第3组的动脉血气显示动脉血氧分压和动脉血氧饱和度显著增加，但只有第3组的动脉血二氧化碳分压（PaCO₂）显著降低。
补充氧气和无创通气有助于重度至极重度COPD患者进行更高强度的运动，因此增强了肺康复的益处。
