口咽部肌训练联合肺康复在IPF-OSA患者中的临床应用效果  

Clinical application effect of oropharyngeal muscle training combined with pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis complicating obstructive sleep apnea

作　　者：胡凤英 马祥 单卿卿 杨潇 黄勇[2] HU Fengying;MA Xiang;SHAN Qingqing;YANG Xiao;HUANG Yong(Second Department of Respiratory and Critical Care Medicine,Chengdu Municipal Hospital of Integrated Traditional Chinese and Western Medicine,Chengdu,Sichuan 610041,China;Department of Respiratory and Critical Care Medicine,Affiliated People’s Hospital of Chongqing University,Chongqing 401147,China)

机构地区：[1]成都市中西医结合医院呼吸与危重症医学科二区,成都610041 [2]重庆大学附属人民医院呼吸与危重症医学科,重庆401147

出　　处：《重庆医学》2024年第7期1041-1044,1049,共5页Chongqing medicine

基　　金：四川省医学会基金项目(S19014)。

摘　　要：目的探讨口咽部肌训练联合肺康复在特发性肺纤维化合并阻塞性睡眠呼吸暂停(IPF-OSA)患者中的临床应用效果。方法选取2020年2月至2023年4月成都市中西医结合医院收治的50例IPF-OSA患者为研究对象。给予入组患者每日2次呼吸训练、每周3次运动训练、每日2次口咽部肌训练,比较患者干预前及干预2个月后血气分析指标、6 min步行距离、肺功能、呼吸肌力测试、呼吸暂停低通气指数(AHI)、疲劳问卷评分、圣乔治问卷评分等。结果干预前后,患者最大吸气压力(MIP)、最大呼气压力(MEP)、6 min步行距离、AHI、氧减指数、氧减时间、夜间最低血氧饱和度、平均血氧饱和度、动脉血氧饱和度、氧分压、用力肺活量(FVC)、第1秒用力肺活量(FEV_(1))、疲劳问卷评分、圣乔治问卷评分比较差异有统计学意义(P<0.05)。相关性分析显示,FVC与MIP、MEP、6 min步行距离呈正相关(r=0.697、0.638、0.629,P<0.05),与疲劳问卷评分、圣乔治问卷评分呈负相关(r=-0.610、-0.805,P<0.05);FEV_(1)与MIP、MEP、6 min步行距离呈正相关(r=0.425、0.739、0.421,P<0.05),与疲劳问卷评分、圣乔治问卷评分呈负相关(r=-0.434、-0.760,P<0.05)。结论口咽部肌训练联合肺康复可以改善IPF-OSA患者的缺氧状态,提高运动耐力,改善生活质量。Objective To explore the clinical application effect of oropharyngeal muscle training combined with pulmonary rehabilitation in the patients with idiopathic pulmonary fibrosis and obstructive sleep apnea(IPF-OSA).Methods Fifty patients with IPF-OSA admitted and treated in Chengdu Municipal Hospital of Integrated Traditional Chinese and Western Medicine from February 2020 to April 2023 were selected as the study subjects.The enrolled patients were given the breathing training twice a day,exercise training three times a week,and oropharyngeal muscle training twice a day.The blood gas analysis,6 min walking distance,pulmonary function,respiratory muscle strength test,apnea hypopnea index(AHI),fatigue questionnaire score and and St.George’s questionnaire scores in the patients were compared between before intervention and in 2 months after intervention.Results The maximal inspiratory pressure(MIP),maximal expiratory pressure(MEP),6 min walking distance,AHI,oxygen desaturation index,oxygen desaturation time,lowest mean oxyhemoglobin saturation,mean arterial oxyhemoglobin saturation,forced vital capacity(FVC),forced expiratory volume in the first second(FEV_(1)),fatigue questionnaire score and St.George’s questionnaire scores had statistical difference between before intervention and after intervention(P<0.05).The correlation analysis showed that FVC was positively correlated with MIP,MEP and 6 min walking distance(r=0.697,0.638,0.629,P<0.05),and negatively correlated with the fatigue questionnaire score and St.George’s questionnaire scores(r=-0.610,-0.805,P<0.05);FEV_(1)was positively correlated with MIP,MEP and 6 min walking distance(r=0.425,0.739,0.421,P<0.05),and negatively correlated with the fatigue questionnaire score and St.George’s questionnaire scores(r=-0.434,-0.760,P<0.05).Conclusion The oropharyngeal muscle training combined with pulmonary rehabilitation could improve the hypoxia status of the patients,increase the exercise endurance and improve the quality of life.

关 键 词：特发性肺纤维化 阻塞性睡眠呼吸暂停 口咽部肌训练 肺康复 

分 类 号：R714.253[医药卫生—妇产科学]