有创-无创序贯通气配合呼吸康复操对AECOPD患者呼吸功能及肺康复的影响

The Effect of Invasive and Non-invasive Sequential Ventilation Combined with Respiratory Rehabilitation Exercise on Respiratory Function and Pulmonary Rehabilitation in Patients with AECOPD

目的探讨有创-无创序贯通气配合呼吸康复操对慢性阻塞性肺疾病急性加重期患者呼吸功能及肺康复的影响。方法随机选取某院2017年11月1日-2018年6月30日入院的AECOPD患者52例作为对照组,按1:1配对原则随机选取2018年7月1日-2019年9月30日入院的AECOPD患者52例作为观察组。对照组给予有创-无创序贯通气,观察组在对照组基础上给予呼吸康复操。对比2组机械通气、住院时间及干预前后血气情况、呼吸状态、肺功能、氧化应激反应、生活质量。结果2组干预后PaCO2水平较干预前降低,且观察组低于对照组;PaO2、pH值、FVC、FEV1、FEV1/FVC水平较干预前增高,且观察组高于对照组(P<0.05);2组干预后呼吸频率、mMRC评分、SGRQ评分较干预前降低,且观察组低于对照组(P<0.05);2组干预后血清MDA水平较干预前降低,且观察组低于对照组,血清SOD水平较干预前增高,且观察组高于对照组(P<0.05);观察组机械通气、住院时间短于对照组(P<0.05)。结论有创-无创序贯通气配合呼吸康复操能通过缓解氧化应激保护肺功能,改善血气状态及生活质量,促进患者康复。

Objective To explore the effect of invasive and non-invasive sequential ventilation combined with respiratory rehabilitation exercise on respiratory function and pulmonary rehabilitation in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 52 AECOPD patients admitted to a hospital from November 1 st,2017 to June 30 th,2018 were randomly selected as the control group,and 52 AECOPD patients admitted to a hospital from July 1 st,2018 to September 30 th,2019 were randomly selected as the observation group according to the 1:1 matching principle.The control group was given invasive-non-invasive sequential ventilation,and the observation group was given respiratory rehabilitation exercise on the basis of the control group.The mechanical ventilation,hospitalization time,blood gas status,respiratory status,lung function,oxidative stress response and quality of life before and after intervention of the two groups were compared.Results The levels of PaCO2 after intervention in the two groups were lower than before the intervention,and the observation group was lower than that in the control group,the levels of PaO2,pH,FVC,FEV1,FEV1/FVC were higher than before the intervention,and the observation group was higher than the control group(P<0.05);the respiratory frequency,mMRC score,and SGRQ score after intervention of the two groups were lower than those before the intervention,and the observation group was lower than the control group(P<0.05);after intervention,the serum MDA level in the two groups was lower than before the intervention,and the observation group was lower than the control group,the serum SOD level was higher than before the intervention,and the observation group was higher than the control group(P<0.05);the duration of mechanical ventilation and hospitalization in the observation group was shorter than that in the control group(P<0.05).Conclusions Invasive and non-invasive sequential ventilation combined with respiratory rehabilitation exercise could protect lung function by reducing oxidative stress,improve blood gas status and quality of life,and promote patient rehabilitation.