康复锻炼联合营养治疗在重症慢性阻塞性肺疾病患者中的应用效果分析

Effect analysis of rehabilitation exercise combined with nutritional therapy for patients with severe chronic obstructive pulmonary disease

目的探讨康复锻炼联合营养治疗在重症慢性阻塞性肺疾病(COPD)患者中的应用效果。方法80例重症COPD患者,按随机数字表法分为对照组和观察组,每组40例。对照组给予常规营养治疗,观察组在对照组基础上实施康复锻炼。比较两组患者干预前后肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)和第1秒用力呼气容积占用力肺活量的比值(FEV1/FVC)]、血气指标[酸碱度(pH值)、动脉血氧分压(PaO_(2))和动脉血二氧化碳分压(PaCO_(2))]、运动耐力和生活质量。结果干预后,观察组患者FEV1、FVC和FEV1/FVC分别为(2.55±0.89)L、(3.99±0.56)L、(69.39±7.68)%,均高于对照组的(1.85±0.30)L、(2.45±0.51)L、(65.47±5.76)%,差异具有统计学意义(P<0.05)。干预后,观察组患者pH值(7.39±0.09)、PaO_(2)(82.43±7.77)mm Hg(1 mm Hg=0.133 kPa)高于对照组的(7.34±0.06)、(71.93±6.29)mm Hg,PaCO_(2)(55.35±5.60)mm Hg低于对照组的(59.29±5.72)mm Hg,差异具有统计学意义(P<0.05)。干预后,观察组患者6 min步行试验(6MWT)距离(340.85±40.85)m长于对照组的(285.66±38.46)m,圣乔治呼吸问卷(SGRQ)评分(45.63±9.78)分低于对照组的(59.64±11.52)分,差异具有统计学意义(P<0.05)。结论重症COPD患者实施康复锻炼联合营养治疗,有利于改善血气指标,提高肺功能和运动耐力,改善其生活质量。

Objective To discuss the application effect of rehabilitation exercise combined with nutritional therapy for patients with severe chronic obstructive pulmonary disease(COPD).Methods A total of 80 patients with severe COPD were divided into control group and observation group according to the random numerical table,with 40 cases in each group.The control group received conventional nutritional therapy,and the observation group received rehabilitation exercises on the basis of the control group.Both groups were compared in terms of pulmonary function indexes[forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and FEV1/FVC],blood gas indexes[pH value,arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))],exercise tolerance and quality of life before and after the intervention.Results After the intervention,FEV1,FVC and FEV1/FVC were(2.55±0.89)L,(3.99±0.56)L and(69.39±7.68)%in the observation group,which were higher than(1.85±0.30)L,(2.45±0.51)L and(65.47±5.76)%in the control group,and the differences were statistically significant(P<0.05).After the intervention,pH of(7.39±0.09)and PaO_(2)of(82.43±7.77)mm Hg(1 mm Hg=0.133 kPa)in the observation group were higher than those of(7.34±0.06)and(71.93±6.29)mm Hg in the control group;PaCO_(2)of(55.35±5.60)mm Hg in the observation group was lower than that of(59.29±5.72)mm Hg in the control group;the differences were statistically significant(P<0.05).After the intervention,the 6-min walk test(6MWT)distance of(340.85±40.85)m in the observation group was longer than that of(285.66±38.46)m in the control group;the St.George Respiratory Questionnaire(SGRQ)score of(45.63±9.78)points in the observation group was lower than that of(59.64±11.52)points in the control group;the differences were statistically significant(P<0.05).Conclusion Rehabilitation exercise combined with nutritional therapy can improve the blood gas index,pulmonary function level,exercise endurance and quality of life of patients with severe COPD.