振动呼气正压技术排痰联合呼吸训练对AECOPD患者气道内分泌物的清除效果

Effect of vibration positive expiratory pressure technique for expectoration combined with respiratory training on airway secretion clearance in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探究振动呼气正压技术排痰联合呼吸训练对急性加重期慢性阻塞性肺疾病(AECOPD)患者气道内分泌物清除的影响。方法选择2018至2021年我院进行治疗的85例AECOPD作为研究对象,按数表法将其分为对照组(n=43例)与观察组(n=42例),在治疗期间给予对照组常规干预,在此基础上给予观察组振动呼气正压技术排痰联合呼吸训练,对比2组的肺功能及气道内分泌物清除情况。结果干预7 d后,观察组的用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占用力肺活量比(FEV1/FVC)均高于对照组(P<0.05);干预第1、3、7天,观察组的痰量均多于对照组,痰液颜色低于对照组(P<0.05);干预7 d后,观察组痰液黏稠度为I度的比例高于对照组(P<0.05);干预7 d后,观察组的肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)水平均低于对照组,白介素-10(IL-10)水平则高于对照组(P<0.05)。结论对AECOPD患者应用振动呼气正压技术排痰联合呼吸训练干预,可有效改善其肺功能,促进排痰,降低炎性反应,有助于气道内分泌物的清除。

Objective To explore the effect of vibratory positive expiratory pressure technique for expectoration combined with respiratory training on the clearance of airway secretions in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPDD).Methods A total of 85 AECOPD patients treated in our hospital from January 2018 to December 2021 were selected as the research objects,and they were randomly divided into the control group(n=43)and the observation group(n=42).During the treatment period,routine intervention was given to all patients,and vibration positive expiratory pressure technique for expectoration combined with respiratory training was additionally given to those in the observation group.The pulmonary function and airway secretion clearance were compared between the two groups.Results After 7 days of intervention,the forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1)and forced expiratory volume in 1 second(FEV1/FVC)ratio in the observation group were significantly higher than those in the control group(P<0.05).On the 1st,3rd,and 7th days of intervention,the sputum volume in the observation group was significantly more than that in the control group,and the color of sputum was significantly lighter than that in the control group(P<0.05).After 7 days of intervention,the levels of tumor necrosis factor(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)in the observation group were significantly lower than those in the control group,while IL-10 was significantly higher(P<0.05).Conclusion The application of vibration positive expiratory pressure technology for expectoration combined with respiratory training intervention in AECOPD patients can effectively improve their lung function,promote expectoration,reduce inflammatory response,and clear airway secretions.