主动呼吸循环技术对急性加重期慢性阻塞性肺疾病的干预效果

Intervention effects of active cycle of breathing techniques on patients with acute exacerbation of chronic obstructive pulmonary disease

目的评价主动呼吸循环技术(ACBT)对急性加重期慢性阻塞性肺疾病(COPD)患者的干预效果。方法根据日排痰量将70例急性加重期COPD患者分为多痰组和少痰组,每组35例。所有患者均给予ACBT干预(ACBT、体位引流)和常规干预(呼吸科常规护理),采用自身配对设计,密闭信封法确定两种方法的随机干预顺序,观察排痰量、血氧饱和度(SpO2)和心率的变化。结果在多痰组,与呼吸科常规干预比较,ACBT干预使患者干预期间和干预后1 h的排痰量显著增加,干预期间SpO2无明显变化,心率明显降低。在少痰组,与呼吸科常规干预比较,ACBT干预使患者1 d的排痰总量显著增加,干预期间和干预后1 h排痰量则无明显变化,干预期间SpO2和心率明显改善。两组患者经ACBT干预后均未发生严重不良反应。结论 ACBT干预对急性加重期COPD患者有一定的短期排痰和呼吸锻炼效果,且无明显不良反应。

Objective To evaluate the intervention effects of active cycle of breathing techniques （ACBT） on patients with acute exacerbation of chronic obstructive pulmonary disease （COPD）. Methods Seventy patients with acute exacerbation of COPD were divided into the more sputum group （n=35） and less sputum group （n=35） according to the daily sputum weight. All patients underwent the active cycle of breathing techniques （ACBT） intervention （ACBT and postural drainage） and regular intervention （standardised physiotherapy, SP）. The self-paired design was adopted and random intervention sequence of two methods was determined by the sealed envelope method. Changes of the expectorated sputum, SpO2, and heart rate were observed. Results Compared to SP, the sputum weight of patients of the more sputum group intervened by ACBT was significantly increased during the intervention and 1 h after the intervention. SpO2 had no significant changes and the heart rate decreased significantly during the intervention. Compared to SP, the sputum weight of patients of the less sputum group intervened by ACBT was significantly increased during 1d. The sputum weight had no significant changes during the intervention and 1h after the intervention. SpO2 and the heart rate improved significantly during the intervention. Patients of both groups had no serious side effects after being intervened by ACBT. Conclusion The ACBT intervention can help sputum excretion and respiratory exercise in short period of time for acute exacerbation of COPD and has no obvious side effects.