早期肺康复锻炼在慢性阻塞性肺疾病急性加重期治疗中介入时机的研究

Study the Intervention Timing of Early Pulmonary Rehabilitation Exercise in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:探讨早期肺康复锻炼在慢性阻塞性肺疾病急性加重期(AECOPD)治疗中的介入时机。方法:将本院2018年7-12月收治的100例慢性阻塞性肺疾病急性加重期患者作为研究对象,按照随机数字表法分为对照组和观察组,各50例。对照组在AECOPD稳定期进行肺康复训练,持续锻炼时间为12周;观察组在AECOPD感染得到控制后即开始进行早期肺康复训练,持续锻炼时间为12周。比较两组康复前后的第一秒用力呼吸容积占预计值百分比(FEV1%pred)、FEV1/FVC%、运动耐力(6 min步行距离)、mMRC评分及血气分析指标的差异。结果:康复后,观察组FEV1%pred、FEV1/FVC%水平均高于康复前和同期的对照组,差异均有统计学意义(P<0.05);康复后,观察组6 min步行距离均长于康复前和同期的对照组,差异均有统计学意义(P<0.05);康复后,观察组m MRC评分均低于康复前和同期对照组,差异均有统计学意义(P<0.05);康复后,观察组PaO2水平均高于康复前和同期的对照组,差异均有统计学意义(P<0.05),其PaCO2水平均低于康复前和同期的对照组,差异均有统计学意义(P<0.05)。结论:AECOPD感染得到控制后进行早期肺康复训练对AECOPD患者临床效果佳,其可改善肺功能、运动耐力,值得临床推广应用。

Objective:To explore the intervention timing of early pulmonary rehabilitation exercise in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method:100 AECOPD patients treated from July 2018 to December 2018 were selected,according to random number table method,the patients were divided into control group and observation group,with 50 cases in each group.The control group took the pulmonary rehabilitation exercise at stable stage for 12 weeks.Upon the control of infection,the observation group took the early pulmonary rehabilitation exercise for 12 weeks.The values of first second forced expiratory volume(FEV1%pred),FEV1/FVC%,exercise endurance(6-minute walking distance),mMRC score and blood gas analysis index were compared between the two groups.Result:After rehabilitation,the values of FEV1%pred and FEV1/FVC%in the observation group were higher than those before rehabilitation and control group,with statistically significant differences(P<0.05).After rehabilitation,the 6-minute walking distance in the observation group was longer than those before rehabilitation and control group,with statistically significant differences(P<0.05).After rehabilitation,the mMRC score in the observation group was lower than those before rehabilitation and control group,with statistically significant differences(P<0.05).After rehabilitation,the value of PaO2 in the observation group was higher than those before rehabilitation and control group,with statistically significant differences(P<0.05).After rehabilitation,the value of PaCO2 was lower than those before and control group,with statistically significant differences(P<0.05).Conclusion:Early lung rehabilitation training after AECOPD infection is under control has a good clinical effect on AECOPD patients,which can improve lung function and exercise endurance,and is worthy of clinical promotion and application.