进阶式早期肺康复锻炼治疗呼吸衰竭的临床效果及对并发症的影响

The Clinical Effect of Advanced Early Pulmonary Rehabilitation Exercise on Respiratory Failure and Its Effect on Complications

目的:探讨进阶式早期肺康复锻炼治疗呼吸衰竭患者的效果及对并发症的影响。方法:选取2017年8月-2019年8月于本院重症医学科(ICU)住院的70例呼吸衰竭患者为研究对象,按随机数字表法分为观察组与对照组,各35例。对照组给予常规药物,观察组在对照组基础上行进阶式早期肺康复锻炼。比较两组氧合指数、住院相关指标、肺功能、运动耐力、血气分析、呼吸困难程度及并发症发生情况。结果:治疗7、14 d后,观察组氧合指数均高于对照组(P<0.05);观察组呼吸机使用、ICU治疗及住院时间均明显短于对照组(P<0.05);治疗14 d后,观察组第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气容积占用力肺活量的比值(FEV1/FVC%)、6 min步行试验(6MWT)及氧分压(PaO2)均明显高于对照组,而二氧化碳分压(PaCO2)与改良版英国医学研究委员会呼吸问卷(mMRC)级数均低于对照组(P<0.05);观察组并发症发生率明显低于对照组(P<0.05)。结论:进阶式早期肺康复锻炼有助于改善呼吸衰竭患者的肺功能,可缩短患者治疗时间,减少并发症,提升运动耐力。

Objective:To investigate the effect of advanced early pulmonary rehabilitation exercise on the patients with respiratory failure and its effect on the complications.Method:A total of 70 patients with respiratory failure admitted to the intensive care unit(ICU)of our hospital from August 2017 to August 2019 were selected as the study objects.They were divided into observation group and control group according to the random number table method,35 cases in each group.The control group was given conventional drugs,and the observation group was given advanced early pulmonary rehabilitation exercise based on the control group.Oxygenation index,hospitalization index,pulmonary function,exercise endurance,blood gas analysis,degree of dyspnea and complications were compared between the two groups.Result:After 7 and 14 d of treatment,the oxygenation index of the observation group were higher than those of the control group(P<0.05).The ventilator use,ICU treatment and hospital stay time in the observation group were significantly lower than those in the control group(P<0.05).After 14 d of treatment,forced expiratory volume in the first second(FEV1)and forced vital capacity(FVC),the ratio of forced expiratory volume to forced vital capacity in the first second(FEV1/FVC%),6 min walk test(6MWT)and oxygen partial pressure(PaO2)of the observation group were significantly higher than those of control group,while carbon dioxide pressure(PaCO2)and modified Medical Research Council dyspnoea scale(mMRC)were lower than those of the control group(P<0.05).The complication rate in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Advanced early pulmonary rehabilitation exercise is helpful to improve the pulmonary function of patients with respiratory failure,it can shorten the treatment time,reduce complications and improve exercise endurance.