呼吸功能锻炼结合运动疗法在肺动脉高压患者心脏康复的应用研究

Application of respiratory exercise combined with exercise therapy in cardiac rehabilitation of patients with pulmonary hypertension

目的研究呼吸功能锻炼结合运动疗法对肺动脉高压患者心脏康复的作用。方法选取2018年3月至2019年6月住院的肺动脉高压(PH)患者60例作为研究对象,采用随机数字表法将患者分为观察组30例、对照组30例,对照组采用运动疗法进行干预,观察组在其基础上采用呼吸功能锻炼进行联合干预,观察2组患者干预前后心肺运动实验结果、动脉血气指标变化、生命质量评分情况。结果观察组干预后耗氧量、二氧化碳排出量、潮气末氧分压、潮气末二氧化碳分压、氧脉搏、无氧阈、呼吸无效腔/潮气量比值分别为(1498.21±347.55)ml/min、(18.23±4.11)ml-1·kg-1、(110.35±21.54)mmHg(1 mmHg=0.133 kPa)、(34.55±8.72)mmHg、(9.82±2.31)ml/次、(13.57±3.20)ml-1·kg-1、(24.51±5.36)%,与对照组(1258.69±287.43)ml/min、(15.53±4.70)ml-1·kg-1、(135.28±18.37)mmHg、(28.57±6.28)mmHg、(6.02±1.83)ml/次、(8.35±1.72)ml-1·kg-1、(30.43±4.51)%比较,差异有统计学意义(t值为2.369~7.870,P<0.05)。干预后观察组PaO2、PaCO2分别为(78.55±8.78)、(38.67±5.20)mmHg,与对照组(71.65±6.38)、(43.28±5.51)mmHg比较,差异有统计学意义(t值为3.482、3.333,P<0.05)。观察组干预后生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、健身健康评分分别为(90.62±15.40)、(79.51±14.72)、(85.61±18.37)、(69.55±13.21)、(70.29±15.07)、(86.85±15.28)、(76.45±18.47)、(72.65±13.18)分,与对照组(78.66±12.33)、(70.88±11.52)、(75.51±13.05)、(61.36±8.55)、(63.33±11.02)、(77.80±10.22)、(68.35±11.56)、(65.53±10.55)分比较,差异有统计学意义(t值为2.036~3.321,P<0.05)。结论呼吸功能锻炼结合运动疗法对肺动脉高压患者心脏康复具有较好效果。

Objective To study the effect of respiratory function exercise combined with exercise therapy on cardiac rehabilitation of patients with pulmonary hypertension.Methods Totally 60 patients with pulmonary hypertension(PH)admitted from March 2018 to June 2019 were selected as the research objects.The patients were divided into observation group(30 cases)and control group(30 cases)by the method of random number table.The control group was intervened by exercise therapy,and the observation group was intervened by respiratory function exercise on the basis of which,the cardiopulmonary movement before and after the intervention was observed.The results of the experiment,the changes of arterial blood gas index and the score of quality of life.Results Observation group after intervention oxygen consumption,carbon dioxide output end-tidal oxygen partial pressure,end-tidal carbon dioxide partial pressure,oxygen pulse anaerobic threshold,respiratory ineffective chamber/tidal volume ratio were(1498.21±347.55)ml/min,(18.23±4.11)ml-1·kg-1,(110.35±21.54)mmHg(1 mmHg=0.133 kPa),(34.55±8.72)mmHg,(9.82±2.31)ml/times,(13.57±3.20)ml-1·kg-1,(24.51±5.36)%,with control group(1258.69±287.43)ml/min,(15.53±4.70)ml-1·kg-1,(135.28±18.37)mmHg,(28.57±6.28)mmHg,(6.02±1.83)ml/times,(8.35±1.72)ml-1·kg-1,(30.43±4.51)%.Differences were statistically significant(t values were 2.369-7.870,P<0.05).Observation group after intervention PaO2,PaCO2 were(78.55±8.78)mmHg,(38.67±5.20)mmHg,with control group(71.65±6.38)mmHg,(43.28±5.51)mmHg.Differences were statistically significant(t values were 3.482,3.333,P<0.05).The observation group's physiological function,physiological function,physical pain,overall health,vitality,social function,emotional function and fitness health score after intervention were respectively(90.62±15.40),(79.51±14.72),(85.61±18.37),(69.55±13.21),(70.29±15.07),(86.85±15.28),(76.45±18.47),(72.65±13.18)points,with control group(78.66±12.33),(70.88±11.52),(75.51±13.05),(61.36±8.55),(63.33±11.02),(77.80±10.22),(68.35±11.56),(65.53±10.55)points.Differences were statistically significant(t values were 2.036-3.321,P<0.05).Conclusion Respiratory function exercise combined with exercise therapy has a good effect on patients with pulmonary hypertension.