肺康复训练治疗支气管肺泡灌洗后老年支气管扩张的临床分析

Clinical analysis of lung rehabilitation training in the treatment of bronchiectasis in elderly patients after bronchoalveolar lavage

目的探究肺康复训练对支气管肺泡灌洗治疗后老年支气管扩张症患者的疗效及安全性。方法纳入2020年2月—2022年3月于空军军医大学第二附属医院收治的老年支气管扩张患者共170例,随机分为观察组(n=85)和对照组(n=85)。对照组患者给予常规治疗及支气管肺泡灌洗治疗,观察组患者在对照组患者治疗基础上联合肺康复训练。通过改良版呼吸困难指数评价患者呼吸困难程度,中文版LCQ-MC咳嗽量表评价患者咳嗽严重程度,圣乔治呼吸问卷评价患者生活质量变化。观察并比较2组患者治疗前后痰量、mMRC评分、LCQ-MC评分及SGRQ评分,以及2组患者治疗效果及不良事件发生率。结果治疗后2组痰量、mMRC评分及SGRQ评分较同组治疗前均显著降低,LCQ-MC评分较同组治疗前均显著升高,且观察组患者较对照组患者以上各指标值变化更明显(P<0.05)。治疗后患者SGRQ评分与患者痰量、mMRC呈正相关性,与LCQ-MC呈负相关性(r=0.239、0.288、-0.203,P<0.05)。观察组患者治疗总有效率显著高于对照组患者(97.65%vs 90.59%,P<0.05),且2组患者不良事件总发生率差异无统计学意义(8.24%vs 7.06%,P>0.05)。结论支气管肺泡灌洗治疗后联合应用肺康复训练可显著改善老年支气管扩张症患者的疗效,且不增加不良事件发生率,减少患者的痰量、降低呼吸困难程度及咳嗽严重程度,提升患者的生活质量,有利于改善患者的预后。

Objective To explore the efficacy and safety of lung rehabilitation training in elderly patients with bronchiectasis after bronchoalveolar lavage.Methods 170 elderly patients with bronchiectasis treated in Second Affiliated Hospital of Air Force Military Medical University from February 2020 to March 2022 were selected and randomly divided into observation group(n=85)and control group(n=85).The control group were treated with routine treatment and bronchoalveolar lavage,and the observation group were treated with lung rehabilitation training based on the treatment of the control group.The degree of dyspnea was evaluated by modified British Medical Research Council(mMRC),severity of cough was evaluated by Chinese version of LCQ-MC Cough Scale,and changes of quality of life were evaluated by St-George s Respiratory Questionnaire(SGRQ).The sputum volume,mMRC score,LCQ-MC score and SGRQ score of the two groups before and after treatment were compared,and the therapeutic effect and incidence of adverse events were compared between the two groups.Results After treatment,the sputum volume,mMRC score,and SGRQ score of the two groups were significantly lower than those of the same group before treatment,while the LCQ-MC score was significantly higher than that of the same group before treatment.Moreover,the improvement of above indicators in the observation group was more significant than that in the control group patients(P<0.05).After treatment,SGRQ score was positively correlated with sputum volume and mMRC score(r=0.239,0.288,P<0.05),and negatively correlated with LCQ-MC score(r=-0.203,P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(97.65%vs 90.59%,P<0.05),and there was no significant difference in the total incidence of adverse events between the two groups(8.24%vs 7.06%,P>0.05).Conclusion After bronchoalveolar lavage treatment,the combined application of lung rehabilitation training can significantly improve the curative effect of elderly patients with bronchiectasis,without increasing the incidence of adverse events.At the same time,it can also reduce the patient s sputum volume,reduce the degree of dyspnea and the severity of cough,improve the quality of life of the patients,and improve their prognosis.