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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.

DOI:10.1111/crj.70049
PMID:39909832
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11798664/
Abstract

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.

摘要

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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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.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
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本文引用的文献

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Individualized Nursing Interventions in Patients with Comorbid Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.合并慢性阻塞性肺疾病和慢性心力衰竭患者的个体化护理干预。
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Geriatr Nurs. 2023 May-Jun;51:238-244. doi: 10.1016/j.gerinurse.2023.03.011. Epub 2023 Apr 4.
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Inspiratory muscle training, with or without concomitant pulmonary rehabilitation, for chronic obstructive pulmonary disease (COPD).吸气肌训练,联合或不联合肺康复治疗,用于慢性阻塞性肺疾病(COPD)。
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Chronic Obstructive Pulmonary Disease Patients With High Peripheral Blood Eosinophil Counts Have Better Predicted Improvement in 6MWD After Rehabilitation: A PRELIMINARY STUDY.外周血嗜酸性粒细胞计数高的慢性阻塞性肺疾病患者康复后6分钟步行距离的预测改善情况更佳:一项初步研究
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Pulmonary rehabilitation ameliorates regional lung function in chronic obstructive pulmonary disease: a prospective single-arm clinical trial.肺康复改善慢性阻塞性肺疾病患者的局部肺功能:一项前瞻性单臂临床试验。
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Effect of modified Total Body Recumbent Stepper training on exercise capacity and thioredoxin in COPD: a randomized clinical trial.改良全身卧床踏步训练对 COPD 患者运动能力和硫氧还蛋白的影响:一项随机临床试验。
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