精准肺康复护理干预联合同步吸入治疗及无创通气对慢性阻塞性肺疾病合并慢性高碳酸血症呼吸衰竭患者的影响
Effect of Precise Pulmonary Rehabilitation Nursing Intervention Combined With Simultaneous Inhalation Therapy and Noninvasive Ventilation for Chronic Obstructive Pulmonary Disease Patients With Chronic Hypercapnic Respiratory Failure.
作者信息
Xiao Jian, Wu Yan, Wang Limei, Zhou Hong
机构信息
Department of Endocrinology, Chinese People's Liberation Army Western Theater Command General Hospital, Chengdu, Sichuan, China.
Department of Respiratory and Critical Care Medicine, Chinese People's Liberation Army Western Theater Command General Hospital, Chengdu, Sichuan, China.
出版信息
Clin Respir J. 2025 Feb;19(2):e70049. doi: 10.1111/crj.70049.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is a progressive heterogeneous pulmonary disorder with an increasing high prevalence, particularly in the older. The objective of this study is to assess the effect of noninvasive ventilation combined with simultaneous nebulization during precise pulmonary rehabilitation nursing intervention in COPD patients with chronic hypercapnic respiratory failure, compared to pulmonary rehabilitation nursing alone.
METHODS
In total, 240 elderly COPD patients with chronic hypercapnic respiratory failure were randomized controlled into either a precise pulmonary rehabilitation nursing model group (control group) or noninvasive ventilation coupled with simultaneous nebulization during pulmonary rehabilitation nursing (intervention group). For our evaluation, we considered general information, pulmonary function, exercise endurance, mental health, blood gas, inflammation, COPD severity, life quality, and overall efficacy of subjects before and on the 5-, 30-, 90-day intervention.
RESULTS
The total effective rates were 95% and 77.5% in the intervention and control group, respectively. In detail, the intervention group showed statistically significant improvements in lung function, exercise endurance, psychological health, blood gas inflammation, overall severity, and quality of life outcomes, especially on the 90-day intervention (p < 0.001).
CONCLUSIONS
The complex COPD patients with chronic hypercapnic respiratory failure may confer more gains from precise pulmonary rehabilitation nursing intervention combined with simultaneous inhalation therapy and noninvasive ventilation.
背景
慢性阻塞性肺疾病（COPD）是一种进行性异质性肺部疾病，患病率日益增高，尤其是在老年人中。本研究的目的是评估与单纯肺部康复护理相比，在慢性高碳酸血症呼吸衰竭的COPD患者进行精准肺部康复护理干预期间，无创通气联合同步雾化的效果。
方法
总共240例患有慢性高碳酸血症呼吸衰竭的老年COPD患者被随机对照分为精准肺部康复护理模式组（对照组）或肺部康复护理期间无创通气联合同步雾化组（干预组）。为了进行评估，我们考虑了受试者在干预前以及干预第5天、30天、90天时的一般信息、肺功能、运动耐力、心理健康、血气、炎症、COPD严重程度、生活质量和总体疗效。
结果
干预组和对照组的总有效率分别为95%和77.5%。具体而言，干预组在肺功能、运动耐力、心理健康、血气炎症、总体严重程度和生活质量结果方面有统计学意义的改善，尤其是在90天干预时（p<0.001）。
结论
患有慢性高碳酸血症呼吸衰竭的复杂COPD患者可能从精准肺部康复护理干预联合同步吸入治疗和无创通气中获益更多。
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