肺康复训练联合无创正压机械通气在慢性阻塞性肺疾病患者中的应用  

Application of pulmonary rehabilitation combined with noninvasive positive-pressure ventilation for patients with chronic obstructive pulmonary disease

作　　者：张波 黄美霞[1] 童晨 ZHANG Bo;HUANG Meixia;TONG Chen(Department of Respiratory and Critical Care Medicine, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, 241002)

机构地区：[1]皖南医学院弋矶山医院呼吸与危重症医学科,安徽芜湖241002

出　　处：《中西医结合护理（中英文）》2020年第7期127-130,共4页Journal of Clinical Nursing in Practice

基　　金：弋矶山医院科技创新团队“攀峰”培育计划项目(PF2019014)。

摘　　要：目的探讨肺康复训练联合无创正压机械通气在慢性阻塞性肺疾病(COPD)患者中的应用效果。方法40例COPD患者随机分为对照组和研究组,各20例。对照组给予无创正压机械通气治疗联合常规护理,研究组在对照组基础上增加早期肺康复训练干预。对比2组患者血气分析指标,采用改良英国医学研究委员会呼吸困难量表(mMRC)评估患者呼吸困难状态,采用Barthel指数评分评估患者日常生活活动能力。结果干预后2组动脉血氧分压(PaO2)和pH值比较,差异无统计学意义(P>0.05)。干预后研究组动脉二氧化碳分压(PaCO2)低于对照组,差异有统计学意义(P<0.01)。干预后,研究组mMRC评分低于对照组,Barthel评分高于对照组,差异有统计学意义(P<0.05)。结论早期肺康复训练联合无创正压机械通气治疗能够缓解COPD患者呼吸困难症状,改善患者血气指标,提升日常生活活动能力。Objective To investigate the effect of pulmonary rehabilitation combined with noninvasive positive-pressure ventilation for patients with chronic obstructive pulmonary disease(COPD).Methods Totally 40 COPD patients were randomly divided into the control group and study group,with 20 cases in each group.All patients received noninvasive positive-pressure ventilation therapy and related nursing care,and those in the study group received additional pulmonary rehabilitation exercise.The indexes of blood gas analysis were compared between two groups.The modified Medical Research Council(mMRC)scale and Barthel Index were used to evaluate dyspnea and activity of daily life in COPD patients,respectively.Results There was no significant difference in partial pressure of oxygen(PaO2)and Blood pH between two groups after intervention(P>0.05).The partial pressure of carbon dioxide(PaO2)in the study group was lower than that in the control group after interventions(P<0.01)。Patients in the study group had lower mMRC scores and higher Barthel index compared with those in the control group after intervention,with significant differences(P<0.05).Conclusion The pulmonary rehabilitation combined with noninvasive positive-pressure ventilation is effective to relieve dyspnea of COPD patients,improve outcomes of blood gas analysis and patients‘activity of daily life.

关 键 词：无创正压机械通气 慢性阻塞性肺疾病 肺康复 日常生活活动能力 呼吸困难 

分 类 号：R473.5[医药卫生—护理学]