体外膈肌起搏联合无创呼吸机对COPD患者呼吸功能及预后的影响  

Effect of external diaphragm muscle pacing and non-invasive ventilator on respiratory function and prognosis of COPD patients

作　　者：唐亮[1] 聂洪玉[1] 沈奕播[1] 徐东兰[1] 刘安忠 TANG Liang;NIE Hongyu;SHEN Yibo;XU Donglan;LIU Anzhong(Department of Respiratory and Critical Care, Zigong Fourth People′s Hospital,Zigong,Sichuan 643000,China;Department of Rehabilitation, Zigong Fourth People′s Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院呼吸与危重症医学科,四川自贡643000 [2]自贡市第四人民医院康复科,四川自贡643000

出　　处：《检验医学与临床》2019年第10期1373-1376,1380,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨体外膈肌起搏联合无创呼吸机对慢性阻塞性肺疾病(COPD)患者呼吸功能及预后的影响。方法选择2015年1月至2017年12月该院收治的82例COPD患者为研究对象,根据治疗方法分为对照组和观察组,每组41例。对照组采用COPD常规方法治疗,观察组采用体外膈肌起搏联合无创呼吸机治疗,两组均治疗14d,治疗完毕后对患者进行12个月随访,评估患者治疗效果。采用德国耶格公司MasterScreen型肺功能测定仪测定两组患者治疗前、治疗14d后第1秒用力呼气容积(FEV1)、用力肺活量(FVC)及二者比值(FEV1/FVC);采用血气分析仪测定两组患者治疗前、治疗14d后动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)和动脉血二氧化碳分压(PaCO2)水平;采用WHOQol-BREF生活量表对两组患者治疗前、治疗12个月后生活质量进行评估;记录并统计两组患者治疗后6个月、12个月再住院率,比较两组患者临床疗效及对呼吸功能、预后的影响。结果观察组患者治疗14d后FEV1、FVC、PaO2、SaO2水平均高于治疗前,PaCO2水平低于治疗前,差异均有统计学意义(P<0.05);观察组治疗14d后FEV1、FVC、PaO2、SaO2水平明显高于对照组,PaCO2水平低于对照组,差异均有统计学意义(P<0.05)。观察组治疗12个月后生理健康、心理状态、社会关系、周围环境、独立能力评分均高于对照组,差异有统计学意义(P<0.05);观察组与对照组治疗6个月后再住院率差异无统计学意义(P>0.05);观察组治疗12个月后再住院率低于对照组,差异有统计学意义(P<0.05)。结论将体外膈肌起搏联合无创呼吸机用于COPD患者有助于改善患者肺功能、血气水平,降低应激反应发生率,能提高患者预后,值得推广应用。Objective To investigate the influence of diaphragm pacing in combination with non-invasive ventilator on respiratory function and prognosis in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 82 patients admitted to COPD from January 2015 to December 2017 were selected as subjects in this study.According to the treatment methods,they were divided into control group ( n =41) and observation group ( n =41).Patients in the control group were treated with routine COPD therapy.Patients in the observation group were treated with in vitro diaphragm pacing and non-invasive ventilator treatment.All the patients were treated for 14 days.After the treatment was completed,the patients were followed for 12 months to evaluate the treatment effect.Pulmonary function tester was used to measure the forced expiratory volume (FEV1),forced vital capacity (FVC) and the ratio of the two indicators (FEV1/FVC) at 1 second before treatment and 14 days after treatment.Arterial partial oxygen pressure (PaO 2),arterial oxygen saturation (SaO 2) and arterial partial carbon dioxide pressure (PaCO 2) levels were measured before and after treatment for 14 days in both groups.WHOQol-BREF life scale was used to evaluate the quality of life in the two groups before treatment and after 12 months of treatment.Records and statistics were taken after 6 months and 12 months of treatment.The rate of rehospitalization was compared with the clinical efficacy in the two groups,and effects of treatments on respiratory function and prognosis were also compared. Results The FEV1,FVC,PaO 2 and SaO 2 levels after 14 days of treatment in the observation group were higher than those before the treatment,the PaCO 2 was lower,the differences were significant ( P <0.05).Meanwhile these indicators after 14 days of treatment between the two group had significant differences ( P <0.05).After 12 months of treatment,healthy and psychological status,social relationship,surrounding environment,and independent ability in the observation group

关 键 词：体外膈肌起搏 无创呼吸机 慢性阻塞性肺疾病 呼吸功能 应激反应 血气水平 

分 类 号：R563.3[医药卫生—呼吸系统]