呼吸训练器与缩唇呼气对AECOPD患者排痰效果的对比研究

A comparative study of the expectoration effect by breath training device and pursed lip breathing in patients with AECOPD

目的比较呼吸训练器与缩唇呼气在慢性阻塞性肺疾病急性加重(AECOPD)患者中的排痰效果。方法于2018年3月至5月因急性加重住院的40例慢性阻塞性肺疾病(COPD)患者随机分为2组,观察和比较呼吸训练器和缩唇呼气的排痰效果。结果呼吸训练器和缩唇呼气干预期间,2组痰液总量和纯痰液容量均比干预前的显著增多(呼吸训练器组:P值均<0.01;缩唇呼气组:P值均<0.05),其中呼吸训练器增加痰液总量比缩唇呼气更显著(P<0.05);呼吸训练器组的痰液水成分容量/痰液总量比值比干预前明显增加(P<0.01),呼吸训练器组的咳嗽难度和痰液性状均比干预前的明显改善(P值均<0.05),呼吸训练器组的痰黏稠度较干预前提高(P<0.05),而缩唇呼气的咳嗽难度、痰液性状和痰黏稠度没有改变;排痰干预后期,2组痰液总量和纯痰液容量均低于干预前期的,2组痰黏稠度均比干预前期增加,其中呼吸训练器组的效果更显著,但咳嗽难度和痰液性状均比干预前期和干预期的明显改善;2组干预期和干预后期,BORG评分和外周氧饱和度均较干预前改善。结论呼吸训练器与缩唇呼气均能帮助AECOPD患者排痰,呼吸训练器更能促进痰水化、改善痰性状和加快排痰。

Objective To observe and compare the expectoration effect of breath training device and the pursed lip breathing in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Forty patients hospitalized because of AECOPD were consecutively observed from March 2018 to May 2018.The patients were randomly divided into two groups in which sputum inducted respectively by breath training device or pursed lip breathing for observing the expectoration effect of the breath training device and the pursed lip breathing.Results During the intervention period of both breath training device and pursed lip breathing,the total volumes expelled and their pure sputum volumes of the two groups were significantly higher than those before the intervention(breath training device group:all P<0.01;pursed lip breathing group:all P<0.05),and the increase of sputum volume by breath training device was more significant than that by pursed lip breathing(P<0.05);the ratio of sputum water component volume to total sputum volume in the breath training device group was also significantly increased than that before the intervention(P<0.01).The cough difficulty and sputum properties in the breath training device group were significantly improved compared with those before intervention(all P<0.05),and the viscosity of sputum in the trainer group was higher than that before intervention(P<0.05),but all of cough difficulty,sputum properties and viscosity of sputum did not in the pursed lip breathing group.After finishing of the intervention,the total sputum volume and pure sputum volume in the two groups were lower than those before the intervention.Although the viscosity of sputum in the two groups were higher than those before intervention,and the viscosity of sputum in the breath training device group was much higher than that in the pursed lip breathing group,the cough difficulty and sputum properties were significantly improved than those before and during the intervention.Conclusions Both breath training device and the pursed lip breathing can help patients with AECOPD to expel phlegm.Breath training device can promote the hydration of phlegm,improve the characteristics of phlegm and speed up the discharge of phlegm.