早期肺康复对慢性阻塞性肺疾病不同级别急性加重期患者的影响

Effect of Early Pulmonary Rehabilitation on Patients with Different Grades of Acute Exacerbation Chronic Obstructive Pulmonary Disease

目的探讨早期肺康复对慢性阻塞性肺疾病(COPD)不同级别急性加重患者的影响。方法选取2019年8月-2021年2月于我院就诊的因非细菌感染导致的COPD急性加重(AECOPD)患者120例,依据严重程度分为1组、2组,各60例,并按照随机数字表法分成治疗一组、治疗二组与治疗三组,各20例。所有患者均按照COPD诊疗指南给予常规治疗,治疗一组入院后第7天开始肺康复训练,治疗二组入院后第14天开始肺康复训练,治疗三组入院后第30天开始肺康复训练。比较患者肺功能、CAT评分、6MWD及动脉血气。结果各组治疗后FVC、FEV1水平均高于治疗前,差异有统计学意义(P<0.05),1组及2组中,治疗一组FVC、FEV1水平高于治疗二组及治疗三组,差异有统计学意义(P<0.05),治疗二组FVC、FEV1水平高于治疗三组,差异有统计学意义(P<0.05)。各组治疗后CAT评分低于治疗前,6MWD高于治疗前,差异有统计学意义(P<0.05),1组及2组中,治疗一组CAT评分低于治疗二组及治疗三组,6MWD高于治疗二组及治疗三组,差异有统计学意义(P<0.05),治疗二组CAT评分低于治疗三组,6MWD高于治疗三组,差异有统计学意义(P<0.05)。在2组中,各组治疗后PaO2水平均高于治疗前,PaCO2水平低于治疗前,差异有统计学意义(P<0.05),各组间PaO2、PaCO2水平比较,差异无统计学意义(P>0.05)。结论COPD急性加重期不同级别患者早期行肺康复有利于缓解呼吸困难症状,改善肺功能,提高运动耐力,但不同级别存在差异。

Objective To explore the effects of early pulmonary rehabilitation on patients with different grades of acute exacerbations of chronic obstructive pulmonary disease(COPD).Methods A total of 120 patients with acute exacerbation of COPD(AECOPD)caused by non-bacterial infection in our hospital from August 2019 to February 2021 were selected and divided into group 1 and group 2 according to the severity,with 60 cases in each group.And according to the random number table method,they were divided into treatment group 1,treatment group 2 and treatment group 3,with 20 cases in each group.All patients were given conventional treatment according to the COPD diagnosis and treatment guidelines,the treatment group 1 was started the pulmonary rehabilitation training on the 7th day after admission,the treatment group 2 was started the pulmonary rehabilitation training on the 14th day after admission,and the treatment group 3 was started the pulmonary rehabilitation training on the 30th day after admission,the pulmonary function,CAT score,6MWD and arterial blood gas were compared.Results After treatment,the levels of FVC and FEV1 in each group were higher than those before treatment,and the difference was statistically significant(P<0.05);the levels of FVC and FEV1 in the treatment group 1 were higher than those in the treatment group 2 and the treatment group 3 between group 1 and group 2,and the difference was statistically significant(P<0.05);the levels of FVC and FEV1 in the treatment group 2 were higher than those in the treatment group 3,and the difference was statistically significant(P<0.05).The CAT score of each group after treatment was lower than that before treatment,and 6MWD was higher than that before treatment,and the difference was statistically significant(P<0.05);the CAT score in the treatment group 1 was lower than that in the treatment group 2 and the treatment group 3,and 6MWD was higher than that in the treatment group 2 and the treatment group 3 between group 1 and group 2,the difference was statistically significant(P<0.05);the CAT score in the treatment group 2 was lower than that in the treatment group 3,and 6MWD was higher than in the treatment group 3,the difference was statistically significant(P<0.05).In group 1 and group 2,after treatment,PaO2 level in each group was higher than that before treatment,PaCO2 level was lower than that before treatment,and the difference was statistically significant(P<0.05),while there was no significant difference in PaO2 and PaCO2 levels between three groups(P>0.05).Conclusion Early pulmonary rehabilitation for patients with different grades of acute exacerbation of COPD is beneficial to relieve symptoms of dyspnea,improve pulmonary function and exercise endurance,but there were differences in different grades.