三球式呼吸训练器联合气道廓清技术对慢性阻塞性肺疾病急性加重患者康复效果的影响

Effect of Three Ball Respiratory Trainer and Airway Clearance Technique on the Rehabilitation of Patients with Acute Aggravation of Chronic Obstructive Pulmonary Disease

目的:探讨三球式呼吸训练器联合气道廓清技术对慢性阻塞性肺疾病急性加重(AECOPD)患者康复效果的影响。方法:将102例AECOPD患者按照随机数字表法分为观察组(予以三球式呼吸训练器联合气道廓清技术)与对照组(予以气道廓清技术),各51例。对比2组干预前后痰量、痰色评分、黏液粘稠度、第1秒用力呼气容积占预计值百分比(FEV1%预计值)、每分钟最大通气量占预计值百分比(MVV%pred)、FEV1/用力肺活量(FVC)、气道峰压、呼吸压力、气道阻力。结果:干预后2组痰量、痰色评分均较干预前降低(P<0.05),观察组更低于对照组(P<0.05)。干预后2组黏液粘稠度较干预前有所改善(P<0.05)。观察组黏液粘稠度改善程度优于对照组(P<0.05)。重复测量方差分析显示,2组FEV1预计值%、MVV%pred、FEV1/FVC存在时间、组间及时间与组间交互作用,差异有统计学意义(P<0.05);干预7、14d后2组FEV1预计值%、MVV%pred、FEV1/FVC均较干预前逐渐提高(P<0.05),2个时间点观察组FEV1预计值%、MVV%pred、FEV1/FVC均高于对照组(P<0.05)。重复测量方差分析显示,2组气道峰压、呼吸压力、气道阻力存在时间、组间及时间与组间交互作用,差异有统计学意义(P<0.05)。干预7、14d后2组气道峰压、呼吸压力、气道阻力均较干预前逐渐降低(P<0.05),2个时间点观察组气道峰压、呼吸压力、气道阻力均低于对照组(P<0.05)。结论:三球式呼吸训练器联合气道廓清技术在AECOPD患者中有利于改善肺功能、呼吸力学及促进痰液排出。

Objective:To explore the impact of a three ball breathing trainer and airway clearance technology on the rehabilitation effect of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:All 102 AECOPD patients were selected as the study subjects.They were randomly divided into an observation group(treated with a triple ball breathing trainer combined with airway clearance technology)and a control group(treated with airway clearance technology)using a random number table method,with 51 patients in each group.The sputum volume,sputum color score,mucus viscosity,percentage of forced expiratory volume in the first second(FEV1%predicted value),percentage of maximum ventilation volume per minute(MVV%pred),FEV1/FVC,peak airway pressure,respiratory pressure,and airway resistance were compared between the two groups.Results:After intervention,sputum volume and sputum color score in 2 groups were significantly lower than before intervention(P<0.05).Compared with control group,sputum volume and sputum color score in the observation group were significantly decreased after intervention(P<0.05).After intervention,the viscosity of the two groups was significantly improved as compared with that before intervention(P<0.05).Compared with the control group,the improvement degree of mucous consistency in the observation group was better than that in the control group(P<0.05).Multiple measurement ANOVA showed that the predicted value of FEV1%,MVV%pred and FEV1/FVC in the two groups had time,inter-group and inter-group interactions,and the differences were statistically significant(P<0.05).The predicted value of FEV1(%),MVV%pred and FEV1/FVC in the 2 groups were significantly higher than those before,and 7 and 14 days after intervention(P<0.05).Compared with the control group,FEV1 predicted value(%),MVV%pred and FEV1/FVC in the observation group were significantly higher than those in the control group(P<0.05).Repeated measurement ANOVA showed that the time,intergroup and intergroup interaction of peak airway pressure,respiratory pressure and airway resistance of the 2 groups were statistically significant(P<0.05).After 7 and 14 days of intervention,the peak airway pressure,respiratory pressure and airway resistance of the 2 groups were decreased as compared with those before intervention(P<0.05).Compared with the control group,the peak airway pressure,respiratory pressure and airway resistance in the observation group were significantly reduced(P<0.05).Conclusion:The combination of a three ball breathing trainer and airway clearance technique is beneficial for improving lung function,respiratory mechanics,and promoting sputum excretion in AECOPD patients.