体外膈肌起搏器治疗在慢性阻塞性肺疾病肺康复中的应用

Application of extracorporeal diaphragmatic pacemaker in pulmonary rehabilitation of chronic obstructive pulmonary disease

目的探究将体外膈肌起搏器应用于慢性阻塞性疾病(COPD)优化肺康复模式效果。方法采用前瞻性研究,选择2019年6月-2020年6月本院呼吸内科及康复医学科收治的中度至极重度稳定期COPD患者共80例作为研究对象,对照组共40例患者行常规内科治疗+呼吸训练,观察组40例常规内科治疗+呼吸训练+膈肌起搏器综合性治疗,通过比较两组患者基础呼吸,肺部感染,肺功能检测,生活自理能力评分情况以及两组患者治疗总有效率及不良反应发生率进,评估两组患者治疗效果是否有统计学差异。结果两组患者一般情况与基础呼吸功能无明显差异(P>0.05)。观察组VC2,PEF,VC,SpO_(2)值显著高于对照组(P<0.05),总体有效率明显高于对照组(P<0.05),两组不良反应发生率无显著性差异(P>0.05)。结论对COPD患者采取呼吸训练联合膈肌起搏器治疗能够有效改善其肺功能及运动功能。可调整呼吸节律,降低呼吸耗能,缓解呼吸困难并提升其生活质量,有望为COPD患者提供一条新的有效肺康复治疗途径。

Objective To explore the effect of external diaphragmatic pacemaker in chronic obstructive pulmonary disease(COPD)in optimizing pulmonary rehabilitation mode.Methods A prospective study,nonrandomized collected 80 patients with moderate to extremely severe stable COPD admitted to the department of respiratory medicine and rehabilitation medicine of our hospital from June2019 to June 2020,as the research objects,with 40 cases of control group routine medical treatment and breathing training,observation group 40 cases of conventional medical treatment and breathing training and diaphragmatic pacemaker was used for comprehensive treatment.Basic respiratory assessment,pulmonary infection,pulmonary function test,self-care ability score,total effective rate and incidence of adverse reactions between the two groups were analyzed and recorded to evaluate the treatment differences between the two groups.Results General condition and basic respiratory function of two group have no significant difference in the two groups(P>0.05).The values of VC2,PEF,VC and SpO_(2)in the observation group were significantly higher than those in the control group(P<0.05).The total effective rate of patients of the test group was higher than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Respiratory training combined with diaphragmatic pacemaker therapy for COPD patients can effectively improve their lung function and motor function,adjust respiratory rhythm,reduce respiratory energy consumption,relieve dyspnea and improve their quality of life,which is expected to provide a new effective pulmonary rehabilitation treatment approach for COPD patients.