慢阻肺合并呼吸衰竭患者应用无创通气联合康复训练对肺功能的改善效果

The Improvement Effect of non-invasive Ventilation combined with Rehabilitation Training on Lung Function in Patients with chronic obstructive pulmonary disease and respiratory Failure

目的探讨慢阻肺合并呼吸衰竭患者应用无创通气联合康复训练对肺功能的改善效果。方法选取2020年1月至2022年12月期间在漯河市妇幼保健院收治的98例慢阻肺合并呼吸衰竭患者,随机分为对照组和观察组,各49例。对照组采用无创通气治疗,观察组在此基础上进行康复训练。比较两组临床指标、肺功能指标、心肺氧合能力以及并发症发生率。结果观察组各项临床指标改善优于对照组,差异有统计学意义(P<0.05)。治疗前,两组的肺功能[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、最大通气量(MVV)]水平比较,差异无统计学意义(P>0.05);治疗后,观察组FEV_(1)、FVC、MVV水平显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组动脉血气指标比较,差异无统计学意义(P>0.05);治疗后,观察组二氧化碳分压(PaCO_(2))水平低于对照组,血氧分压(PaO_(2))、血氧饱和度(SaO_(2))高于对照组,差异有统计学意义(P<0.05)。治疗后,两组心肺氧合能力均有所提高,且观察组最大摄氧量(VO_(2)max)、代谢当量(MET)、主观用力等级(RPE)水平高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率(6.12%)低于对照组(24.49%),差异有统计学意义(P<0.05)。结论无创通气联合康复训练可有效改善慢阻肺合并呼吸衰竭患者肺功能和动脉血气指标,提高心肺氧合能力,降低并发症发生率,缩短病程时间。

Objective To explore the improvement effect of non-invasive ventilation combined with rehabilitation training on lung function in patients with chronic obstructive pulmonary disease(COPD)and respiratory failure.Methods A total of 98 COPD patients complicated with respiratory failure admitted to Luohe Maternal and Child Health Hospital from January 2020 to December 2022 were randomly divided into control group and observation group,with 49 cases in each group.The control group received non-invasive ventilation treatment,while the observation group received rehabilitation training on this basis.The clinical indexes,pulmonary function indexes,cardiopulmonary oxygenation and the incidence of complications were compared between the two groups.Results The improvement of various clinical indicators in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in lung function levels[forced expiratory volume in 1 second(FEV_(1)),forced vital capacity(FVC),maximal voluntary ventilation(MVV)]between the two groups(P>0.05);After treatment,the levels of FEV_(1),FVC,and MVV in the observation group were significantly higher than those in the control group,with statistical significance(P<0.05).Before treatment,there was no statistically significant difference in arterial blood gas indicators between the two groups(P>0.05);After treatment,the observation group had lower levels of partial pressure of carbon dioxide(PaCO_(2))compared to the control group,and higher levels of partial pressure of oxygen(PaO_(2))and oxygen saturation(SaO_(2))compared to the control group,with statistically significant differences(P<0.05).After treatment,the cardiorespiratory oxygenation ability of both groups was improved,and the maximum oxygen uptake(VO_(2)max),metabolic equivalent(MET),and rating of perceived exertion(RPE)levels in the observation group were higher than those in the control group,with statistical significance(P<0.05).The incidence of complications in the observation group(6.12%)was lower than that in the control group(24.49%),and the difference was statistically significant(P<0.05).Conclusion Non-invasive ventilation combined with rehabilitation training can effectively improve lung function and arterial blood gas indicators in patients with chronic obstructive pulmonary disease and respiratory failure,enhance cardiopulmonary oxygenation ability,reduce the incidence of complications,and shorten the duration of the disease.