体外膈肌起搏联合呼吸训练在慢性阻塞性肺疾病稳定期患者中的应用效果  

Application effects of extracorporeal diaphragmatic pacing combined with respiratory training in patients with stable chronic obstructive pulmonary disease

作　　者：张宇航 蒋冬梅 ZHANG Yuhang;JIANG Dongmei(Department of Respiratory and Critical Care Medicine of Shangqiu Municipal Hospital,Shangqiu 476000 Henan,China)

机构地区：[1]商丘市立医院呼吸与危重症医学科,河南商丘476000

出　　处：《中国民康医学》2025年第1期27-29,33,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察体外膈肌起搏联合呼吸训练在慢性阻塞性肺疾病(COPD)患者中的应用效果。方法:选取2020年1月至2023年8月该院收治的126例COPD稳定期患者进行前瞻性研究,按照随机数字表法将其分为对照组与观察组各63例。对照组实施呼吸训练,观察组在对照组基础上联合体外膈肌起搏训练,比较两组训练前后临床症状[改良版英国医学研究委员会呼吸问卷(mMRC)、慢阻肺患者自我评估测试问卷(CAT)]评分、膈肌活动度(DE)、肺功能指标[第1秒用力呼气容积(FEV_(1))占预计值百分比(FEV_(1)%)、FEV_(1)/用力肺活量(FVC)、深吸气量(IC)/肺总量(TLC)]水平和生命质量[简明健康调查量表(SF-36)]评分。结果:训练后,两组mMRC、CAT评分均低于训练前,且观察组低于对照组,差异有统计学意义(P<0.05);对照组DE与训练前比较,差异无统计学意义(P>0.05);观察组DE大于训练前,且大于对照组,差异均有统计学意义(P<0.05);两组FEV_(1)%、FEV_(1)/FVC、IC/TLC水平均高于训练前,且观察组高于对照组,差异有统计学意义(P<0.05);两组SF-36评分均高于训练前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:体外膈肌起搏联合呼吸训练应用于COPD稳定期患者,可减轻临床症状,增大DE,改善肺功能,提高生命质量,效果优于单纯呼吸训练。Objective:To observe application effects of external diaphragmatic pacing combined with respiratory training in patients with chronic obstructive pulmonary disease(COPD).Methods:A prospective study was conducted on 126 patients with stable COPD admitted to the hospital from January 2020 to August 2023.According to the random number table method,they were divided into control group and observation group,63 cases in each group.The control group received respiratory training,while the observation group received external diaphragm pacing training on the basis of that of the control group.The scores of clinical symptoms[modified British medical research council respiratory questionnaire(mMRC)and COPD Patient self-assessment test(CAT)],the diaphragmatic activity(DE),the pulmonary function indexes[forced expiratory volume in one second(FEV_(1))as a percentage of predicted value(FEV_(1)%),FEV_(1)/forced vital capacity(FVC),inspiratory capacity(IC)/total lung capacity(TLC)],and the quality of life[short form health survey scale(SF-36)]were compared between the two groups before and after the training.Results:After the training,the mMRC and CAT scores of the two groups were lower than those before the training,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the DE in the control group before and after the training(P>0.05).The DE of the observation group was higher than that before the training,and higher than that of the control group,and the differences were statistically significant(P<0.05).The levels of FEV_(1)%,FEV_(1)/FVC and IC/TLC in the two groups were higher than those before the training,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The SF-36 scores of the two groups were higher than those before the training,that in the observation group was higher than that in the control group,and the differences were

关 键 词：体外膈肌起搏 呼吸训练 慢性阻塞性肺疾病 肺功能 生命质量 膈肌活动度 

分 类 号：R473.5[医药卫生—护理学]