呼吸功能锻炼联合异丙托溴铵对COPD-OSAHS重叠综合征患者的应用效果  

Effect of respiratory function exercise combined with ipratropium bromide in COPD-OSAHS overlap syndrome

作　　者：陈月华 程利 张祥斌 Chen Yuehua;Cheng Li;Zhang Xiangbin(Department of Respiratory Medicine,Nanping First Hospital affiliated to Fujian Medical University,Nanping 353000,China)

机构地区：[1]福建医科大学附属南平第一医院呼吸内科,353000

出　　处：《国际呼吸杂志》2021年第13期1008-1013,共6页International Journal of Respiration

摘　　要：目的探讨呼吸功能锻炼联合异丙托溴铵对慢性阻塞性肺疾病(COPD)-阻塞性睡眠呼吸暂停低通气综合征(OSAHS)重叠综合征患者的应用效果。方法前瞻性研究。选取2017年6月至2019年3月福建医科大学附属南平第一医院呼吸内科收治的66例COPD-OSAHS重叠综合征患者随机分为对照组和观察组,每组33例。全部患者给予常规治疗,对照组在常规治疗基础上给予异丙托溴铵,观察组在对照组基础上给予呼吸功能锻炼,持续12周。比较2组干预前后的临床症状体征、呼吸功能、疾病控制状况及不良反应发生率。结果2组干预后的临床症状体征评分、动脉血二氧化碳分压(PaCO2)、COPD评估测试(CAT)问卷与Epworth嗜睡量表(ESS)总分均显著低于干预前,第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、动脉血氧分压(PaO2)均显著高于干预前,差异均有统计学意义(P值均<0.05)。观察组干预后的临床症状体征评分、PaCO2、CAT问卷与ESS总分均显著低于对照组,FEV1、FEV1/FVC、PaO2均显著高于对照组,差异均有统计学意义(P值均<0.05)。结论呼吸功能锻炼联合应用异丙托溴铵能显著改善COPD-OSAHS重叠综合征患者的临床症状体征,促进呼吸功能的康复,降低病情严重程度,安全可靠,值得临床推广应用。Objective To investigate the effect of respiratory function exercise combined with ipratropium bromide in chronic obstructive pulmonary disease(COPD)-obstructive sleep apnea-hypopnea syndrome(OSAHS)overlap syndrome.Methods This was a prospective study.A total of 66 patients with COPD-OSAHS overlap syndrome from June 2017 to March 2019 were enrolled from Nanping First Hospital Affiliated to Fujian Medical University for the study and randomly divided into control group and observation group,33 cases in each group.All patients were given conventional symptomatic and respiratory function exercise.On this basis,patients in observation group received ipratropium bromide.The clinical symptoms and signs,respiratory function,disease control and incidence of adverse reactions were compared before and after intervention in two groups.Results The total scores of clinical symptoms and signs,arterial partial pressure of carbon dioxide(PaCO2),COPD Assessment Test(CAT)and Epworth Sleeping Scale(ESS)in two groups were significantly lower after intervention than before intervention,and the forced expiratory volume in the first second(FEV1),FEV1/forced expiratory volume(FVC)and arterial partial pressure of oxygen(PaO2)in two groups were significantly higher after intervention than before intervention(all P<0.05).The scores of clinical symptoms and signs,PaCO2,CAT and ESS scores in observation group were significantly lower after intervention than in control group.FEV1,FEV1/FVC and PaO2 in observation group were significantly higher after intervention than in the control group(all P<0.05).Conclusions Respiratory function exercise combined with ipratropium bromide could significantly improve the clinical symptoms and signs of patients with COPD-OSAHS overlap syndrome,promote the rehabilitation of respiratory function,reduce the severity of the disease,which is safe,reliable and worthy of clinical application.

关 键 词：肺疾病 慢性阻塞性 异丙托溴铵 呼吸功能锻炼 重叠综合征 阻塞性睡眠呼吸暂停低通气综合征 

分 类 号：R563.9[医药卫生—呼吸系统] R766[医药卫生—内科学]