体外膈肌起搏器联合无创通气治疗慢性阻塞性肺疾病的临床研究

Clinical Study of External Diaphragm Pacemaker Combined with Non-invasive Ventilation in the Treatment of Chronic Obstructive Pulmonary Disease

目的:探究体外膈肌起搏器联合无创正压通气在慢性阻塞性肺疾病(COPD)患者中的临床效果及对肺功能的影响。方法:随机选取2016年1月-2018年3月本院收治的50例慢性阻塞性肺疾病患者,根据患者入院治疗单双号分为试验组与对照组,每组25例。对照组采用无创正压通气治疗,试验组采用体外膈肌起搏器联合无创正压通气治疗。分别观察两组临床治疗效果、肺功能(PaO2、PaCO2、PaO2/FiO2、FEV1/FVC、FEV1)、日常生活活动能力量表(ADL)评分。结果:治疗后2周,试验组临床治疗总有效率92.00%高于对照组68.00%,差异有统计学意义(P<0.05);试验组ADL评分(94.64±5.17)分高于对照组(85.71±4.31)分,差异有统计学意义(P<0.05);试验组PaCO2(53.22±3.41)mm Hg、PaO2(89.62±2.41)mm Hg、PaO2/FiO2(410.82±11.97)mm Hg均优于对照组(61.91±3.12)mm Hg、(80.87±2.87)mm Hg、(324.39±12.57)mm Hg,FEV1/FVC、FEV1均高于对照组,两组比较差异均有统计学意义(P<0.05)。结论:与单一使用无创正压通气治疗相比,给予COPD患者使用体外膈肌起搏器联合无创正压通气不仅利于提升临床治疗效果,更利于改善其肺功能,进而提升日常生活活动能力,具有独特的应用价值,值得临床进一步推广应用。

Objective:To explore the clinical effect of external diaphragm pacemaker combined with noninvasive positive pressure ventilation in patients with chronic obstructive pulmonary disease(COPD)and its effect on pulmonary function.Method:A total of 50 patients with chronic obstructive pulmonary disease were randomly selected from January 2016 to March 2018.According to the odd and even number of admission treatment,they were divided into experimental group and control group,25 cases in each group.The control group was treated with non-invasive positive pressure ventilation.The experimental group was treated with external diaphragm pacemaker combined with non-invasive positive pressure ventilation.The clinical effect,pulmonary function(PaO2,PaCO2,PaO2/FiO2,FEV1/FVC,FEV1)and activity of daily living(ADL)scores of two groups were observed.Result:After treatment two weeks,the total effective rate of the experimental group was 92.00%higher than the control group of 68.00%,the difference was statistically significant(P<0.05).The ADL score of the experimental group was(94.64±5.17)score higher than the control group of(85.71±4.31)score,the difference was statistically significant(P<0.05).The PaCO2(53.22±3.41)mm Hg,PaO2(89.62±2.41)mm Hg,PaO2/FiO2(410.82±11.97)mm Hg of the experimental group were better than the control group of(61.91±3.12)mm Hg,(80.87±2.87)mm Hg,(324.39±12.57)mm Hg,the levels of FEV1/FVC、FEV1 in the experimental group were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Compare with the single use of non-invasive positive pressure ventilation,the external diaphragm pacemaker combined with non-invasive positive pressure ventilation in the treatment for patients with COPD is not only conducive to improve the clinical efficacy,but also conducive to improve their pulmonary function,and thus enhance the ability of daily living,has a unique application value.It is worthy further of clinical application.