无创正压通气辅助踏车运动在稳定期重度慢性阻塞性肺疾病患者中的疗效探讨

The Effect of Noninvasive Positive Pressure Ventilation Assisted Bicycle Exercise in Patients with Stable Severe Chronic Obstructive Pulmonary Disease

目的:探讨无创正压通气(NIPPV)辅助踏车运动在稳定期重度慢性阻塞性肺疾病(慢阻肺)患者中的应用效果。方法:选取2017年3月-2018年3月32例稳定期重度慢阻肺患者,均接受两个月的无创正压通气辅助踏车运动,通过自身对照,测定治疗前和治疗两个月后12 min步行距离(12 MWD)、Borg呼吸困难指数评分、平均肺动脉压(mPAP)、日间动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、1年内慢阻肺急性加重次数。结果:与治疗前对比,患者治疗后12 MWD增加,Borg呼吸困难指数评分降低,1年内急性加重次数减少,差异均有统计学意义(P<0.05)。治疗后,患者mPAP、PaCO2较治疗前降低,PaO2较治疗前升高,差异均有统计学意义(P<0.05)。结论:无创正压通气辅助踏车运动使稳定期重度慢阻肺患者运动耐力提高,呼吸困难症状得到有效缓解,1年内慢阻肺加重情况明显改善,可在临床上推广应用。

Objective:To investigate the effect of noninvasive positive pressure ventilation(NIPPV) assisted bicycle exercise in patients with stable severe chronic obstructive pulmonary disease(COPD).Method:From March 2017 to March 2018,32 patients with stable severe COPD were selected.All patients received two months of noninvasive positive pressure ventilation assisted bicycle exercise,12 minutes walking distance(12 MWD),Borg dyspnea index score,mean pulmonary artery pressure(mPAP),diurnal partial arterial oxygen pressure(PaO2),partial pressure of carbon dioxide(PaCO2) and the number of chronic obstructive pulmonary disease(COPD) exacerbations in one year were measured by self-control.Result:Compared to before treatment,12 minutes walking distance increased,Borg dyspnea index score decreased,and the number of exacerbations in one year decreased after treatment,and the differences were statistically significant(P<0.05).After treatment,the mPAP and PaCO2 of patients decreased,while PaO2 increased than before treatment,and the differences were statistically significant(P<0.05).Conclusion:Noninvasive positive pressure ventilation assisted bicycle exercise can improve the exercise endurance of patients with stable severe COPD,relieve the symptoms of dyspnea effectively,and improve COPD exacerbations in one year,which can be popularized and applied in clinic.