早期肺康复训练在慢性阻塞性肺疾病急性加重期应用无创机械通气下快速康复护理中的应用

Effect of early PR training on patients with COPD under NPPV

目的探讨早期肺康复训练在慢性阻塞性肺疾病(COPD)病人急性加重期应用无创正压通气下快速康复护理中的应用效果及护理方法。方法选取2016年2月至2017年12月芜湖市第五人民医院收治入院的COPD急性加重期应用无创机械通气(NPPV)病人60例,采用随机数字表法分为观察组(早期肺康复训练组)30例和对照组(常规护理组)30例,分别统计两组肺功能指标改善情况、NPPV时间、氧合指数测定、COPD病人自我评估测试(CAT)评分和病人焦虑、抑郁评分变化。结果观察组肺功能指标[肺活量(VC),最大通气量(MVV)和第1秒用力呼气容积(FEV1)]分别为67.16%±7.07%、60.55%±9.71%、89.11%±10.59%,对照组分别为63.63%±6.16%、55.14%±9.54%、83.59%±10.34%,观察组较对照组高,差异有统计学意义(P<0.05);观察组NPPV时间为(6.2±2.7)d、氧合指数为(380.65±19.17)、CAT评分为(8.82±2.82)分,对照组分别为(8.1±3.3)d、(369.14±18.61)、(12.02±2.78)分,观察组NPPV时间较对照组下降,氧合指数较对照组升高、CAT评分较对照组下降,差异有统计学意义(P<0.05);观察组焦虑、抑郁状态评分较对照组下降,差异有统计学意义(P<0.05)。结论早期肺康复训练可改善COPD无创机械通气病人肺功能指标、提高病人氧合指数,降低无创机械通气时间,促进健康相关生活质量改善,减轻焦虑抑郁,且操作易行并最经济。

Objective To explore nursing effect and nursing methods of early pulmonary rehabilitation(PR)training for the pa?tients with chronic obstructive pulmonary disease(COPD)in acute aggravating period for fast recovery with on?invasive positive pressure ventilation(NPPV).Methods Sixty cases of acute exacerbation of COPD with non?invasive mechanical ventilation in The No.5 People’s Hospital of Wuhu from February 2016 to December 2017 were selected and randomly assigned into the Test Group(Early PR group)and the Control Group(Routine care group)with 30 cases in each.The improvement of pulmonary func?tions,NPPV time,oxygenation index,COPD self?assessment test score and patient anxiety and depression score in the two groupswere measured and calculated.Results The pulmonary functions including vital capacity(VC),maximal voluntary ventilation(MVV),forced expiratory volume 1 second(FEV1)of the patients in the test group were higher than those in the control group,and the differences were statistically significant[VC:67.16%±7.07% vs.63.63%±6.16%,MVV:60.55%±9.71% vs.55.14%±9.54%,FEV1:189.11%±10.59% vs. 83.59%±10.34%,P<0.05];the NPPV time in test group was lower than that in the control group[(6.2±2.7)d vs.(8.1±3.3)d,P<0.05];the oxygenation index in test group was higher than that in the control group[(380.65±19.17)vs.(369.14±18.61),P<0.05];the CAT score was lower than that in the control group[(8.82±2.82)vs.(12.02±2.78),P<0.05].Patient anxiety and depression scores in test group were better than those in the control group,and the difference was statisti?cally significant(P<0.05).Conclusion Early PR training can improve patients’lung function,enhance their oxygenation,reduceNPPV time,promote their health related quality of life,relieve their anxiety depression,improve tolerability and promote rapid re?covery.The method is easy to operate and low?cost.