无创呼吸机结合渐进式肺康复训练对改善慢性阻塞性肺疾病肺功能及预后的影响研究

Effect of non-invasive ventilation combined with progressive lung rehabilitation training on improving lung function and prognosis in patients with chronic obstructive pulmonary disease

目的观察无创呼吸机结合渐进式肺康复训练对改善慢性阻塞性肺疾病(COPD)患者肺功能及预后情况的影响。方法本文为前瞻性研究,纳入驻马店市中心医院2020年6月至2022年4月收治的100例COPD患者为研究对象,经数字表法将其分为常规组和联合组,各50例。常规组予以常规药物治疗结合渐进式肺康复训练,联合组采用无创呼吸机辅助干预,所有患者均开展为期1年随访,比较两组患者治疗前后的炎症指标、肺动脉血气指标、肺功能、相关症状及生存改善情况。结果联合组治疗后的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)分别为(125.33±20.66)ng/L、(133.49±20.72)pg/mL,均低于常规组[(140.35±20.47)ng/L、(150.36±20.24)pg/mL](P<0.05);联合组治疗后的血氧饱和度(SO_(2))、动脉氧分压(PO_(2))分别为(96.26±5.44)%、(83.35±10.47)mmHg,均高于常规组[(93.21±5.25)%、(77.36±10.25)mmHg],动脉二氧化碳分压(PCO_(2))为(40.23±10.12)mmHg,低于常规组[(45.66±10.27)mmHg](P<0.05);联合组治疗后的第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、每分钟最大通气量(MVV)分别为(57.72±10.46)%、(2.76±0.45)L、(67.25±10.41)L/min,均高于常规组[(51.69±10.33)%、(2.31±0.26)L、(62.33±10.23)L/min](P<0.05);联合组随访期间的呼吸困难指数(mMRC)、慢阻肺评估测试(CAT)评分分别为(2.25±0.36)分、(20.33±5.45)分,均低于常规组[(2.88±0.26)分、(23.44±5.15)分],慢性阻塞性肺疾病生活质量评价表(QLICD-COPD)评分为(78.22±10.36)分,高于常规组[(72.11±10.49)分](P<0.05)。结论无创呼吸机结合渐进式肺康复训练能有效缓解COPD患者的肺部炎症及肺动脉血气指标,对促进患者肺功能及相关症状康复,并改善生存质量均有积极意义。

【Objective】To observe the impact of non-invasive ventilation combined with progressive lung rehabilitation training on improving lung function and prognosis in chronic obstructive pulmonary disease(COPD)patients.【Methods】This article is a prospective study that randomly selected 100 COPD patients admitted between June 2020 and April 2022 as the study subjects.They were divided into a conventional group(50 cases)and a combined group(50 cases)using a digital table method.The conventional group received routine drug therapy combined with progressive lung rehabilitation training,while the combined group received non-invasive ventilator assisted intervention.All patients underwent a one-year follow-up to compare the inflammatory indicators,pulmonary arterial blood gas indicators,pulmonary function,related symptoms,and survival improvement of the two groups before and after treatment.【Results】After intervention,the levels of IL-6 and IL-8 in the combined group were 125.33±20.66 ng/L and 133.49±20.72 pg/mL,respectively,lower than those in the conventional group(140.35±20.47 ng/L and 150.36±20.24 pg/mL)(P<0.05).After intervention,the SO_(2) and PO_(2) levels in the combined group were 96.26%±5.44%and 83.35±10.47 mmHg,respectively,which were higher than those in the conventional group(93.21%±5.25%and 77.36±10.25 mmHg).The PCO_(2) levels were 40.23±10.12 mmHg,which were lower than those in the conventional group 45.66±10.27 mmHg(P<0.05).The FEV1,FVC,and MVV of the combined group after intervention were 57.72%±10.46%,2.76±0.45 L,and 67.25±10.41 L/min,respectively,higher than those of the conventional group(51.69%±10.33%,2.31±0.26 L,and 62.33±10.23 L/min)(P<0.05).During the follow-up period,the mMRC and CAT scores of the combined group were 2.25±0.36 points and 20.33±5.45 points,respectively,which were lower than those of the conventional group(2.88±0.26 points,23.44±5.15 points).The QLICD-COPD score was 78.22±10.36,which was higher than that of the conventional group(72.11±10.49)(P<0.05).【Conclusion】The combination of non invasive ventilation and progressive lung rehabilitation training can effectively alleviate pulmonary inflammation and pulmonary arterial blood gas indicators in COPD patients,promote the recovery of lung function and related symptoms,and improve the quality of life of patients with positive significance.