[Objectives]To systematically evaluate the effects of early-stage phased rehabilitation training on the oxygenation index,ICU length of stay,duration of mechanical ventilation,and occurrence of complications(ventilato...[Objectives]To systematically evaluate the effects of early-stage phased rehabilitation training on the oxygenation index,ICU length of stay,duration of mechanical ventilation,and occurrence of complications(ventilator-associated pneumonia,pressure ulcers,delirium)in ARDS patients,thus contributing evidence for the clinical application of early-stage phased rehabilitation training.[Methods]The China National Knowledge Infrastructure(CNKI),Wanfang,and other databases were searched.Literature screening,data extraction,and systematic analysis of the included studies were performed using Revman software.[Results]Thirteen randomized controlled trials involving a total of 860 patients were included in this review.The results of the meta-analysis showed that compared to the traditional rehabilitation training group,the early-stage phased rehabilitation training group demonstrated a significant increase in the oxygenation index of ARDS patients[SMD=1.18,95%CI(1.01,1.35),P<0.01],with statistically significant differences.Furthermore,there were significant reductions in ICU length of stay[SMD=-0.70,95%CI(-0.90,-0.50),P<0.01],duration of mechanical ventilation[SMD=-1.15,95%CI(-1.36,-0.94),P<0.01],and occurrence of complications[OR=0.16,95%CI(0.10,0.26),P<0.01],all of which were statistically significant.[Conclusions]Early-stage phased pulmonary rehabilitation training for ARDS patients effectively improves the oxygenation index,shortens ICU length of stay and duration of mechanical ventilation,and reduces complications.These findings support the clinical application and promotion of early-stage phased rehabilitation training.展开更多
目的:研究布地格福联合K5压力阈值吸气肌训练对慢阻肺急性加重期(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者呼吸力学参数及生命质量的影响。方法:选取2022年1月至2024年1月在赣州市第五人民医院就诊的8...目的:研究布地格福联合K5压力阈值吸气肌训练对慢阻肺急性加重期(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者呼吸力学参数及生命质量的影响。方法:选取2022年1月至2024年1月在赣州市第五人民医院就诊的80例慢阻肺急性加重期患者作为研究对象,按照随机数字表分为对照组和观察组,各40例。对照组使用布地格福进行治疗,观察组在对照组的基础上联合K5压力阈值吸气肌训练治疗,两组均治疗30d。分别比较患者治疗前后的圣乔治评分(St.George's Respiratory Questionnaire,SGRQ)、6分钟步行试验(6-minute walk test,6MWT)、最大吸气压(Maximum inspiratory pressure,MIP),并通过测量第1秒呼气量(Forced Expiratory Volume in the first second,FEV1)、用力肺活量(Forced Vital Capacity,FVC)、弥散功能血氧饱和度(Oxygen saturation of blood,SaO_(2))、动脉氧分压(Arterial Oxygen Partial Pressure,PO_(2))、动脉二氧化碳分压(Partial pressure of arterial carbon dioxide,PCO_(2))对肺功能和血气指标进行比较分析,对其进行比较分析。结果:观察组的SGRQ三项评分均低于对照组(P<0.05);治疗后观察组的6MWT和MIP两项都比对照组高(P<0.05);观察组的FEV1、FVC和弥散功能三项指标都高于对照组(P<0.05);观察组的SaO_(2)和PO_(2)明显高于对照组,PCO_(2)明显低于对照组(P<0.05)。结论:布地格福吸入气雾剂联合K5压力阈值吸气肌训练能有效减轻患者的症状,改善呼吸力学参数并提高生命质量,延长患者生存时间。展开更多
目的分析呼吸训练联合无创呼吸机对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并呼吸衰竭患者呼吸功能和预后的影响。方法选取本院2016年3月至2017年3月收治的120例AECOPD合...目的分析呼吸训练联合无创呼吸机对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并呼吸衰竭患者呼吸功能和预后的影响。方法选取本院2016年3月至2017年3月收治的120例AECOPD合并Ⅱ型呼吸衰竭患者为研究对象。采用随机数表法将入选患者分为观察组和对照组,每组各60例,均给予综合对症治疗和无创呼吸机治疗,观察组患者在此基础上接受呼吸训练。比较两组患者治疗前后血气指标、呼吸功能、急性生理学和慢性健康状况评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、辅助呼吸肌评分,并评价患者预后、日常生活活动能力和生活质量。结果两组患者治疗后动脉血pH、动脉血氧分压(arterial partial pressure of oxygen,PaO2)、动脉血氧饱和度(arterial oxygen saturation,SaO2)均显著高于本组治疗前(均P<0.05),动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO2)均显著低于本组治疗前(均P<0.05)。治疗后24 h和72 h,观察组患者pH、PaO2、SaO2均显著高于同期对照组(均P<0.05),PaCO2均显著低于同期对照组(均P<0.05)。两组患者治疗后1周第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1与用力肺活量(forced vital capacity,FVC)比值(FEV1/FVC)、FEV1%预测值均显著高于本组治疗前(均P<0.05),APACHEⅡ评分、辅助呼吸肌评分均显著低于本组治疗前(均P<0.05)。治疗后1周,观察组患者FEV1、FEV1/FVC、FEV1%预测值均显著高于对照组(均P<0.05),APACHEⅡ评分、辅助呼吸肌评分均显著低于对照组(均P<0.05)。观察组患者住院天数、插管率均显著低于对照组(均P<0.05),两组患者病死率比较差异无统计学意义(P>0.05)。剔除病死患者后结果显示,两组患者治疗后功能独立性评定量表(functional independence measure,FIM)评分和世界卫生组织生活质量测定量表简表(brief version of WHO quality of life,WHOQOL-BREF)评分均显著高于本组治疗前(均P<0.05)。治疗后90 d和180 d,观察组患者FIM评分和WHOQOL-BREF评分均显著高于同期对照组(均P<0.05)。结论在无创呼吸机的基础上加用呼吸训练能够明显改善AECOPD合并呼吸衰竭患者的呼吸功能和预后,值得推广。展开更多
文摘[Objectives]To systematically evaluate the effects of early-stage phased rehabilitation training on the oxygenation index,ICU length of stay,duration of mechanical ventilation,and occurrence of complications(ventilator-associated pneumonia,pressure ulcers,delirium)in ARDS patients,thus contributing evidence for the clinical application of early-stage phased rehabilitation training.[Methods]The China National Knowledge Infrastructure(CNKI),Wanfang,and other databases were searched.Literature screening,data extraction,and systematic analysis of the included studies were performed using Revman software.[Results]Thirteen randomized controlled trials involving a total of 860 patients were included in this review.The results of the meta-analysis showed that compared to the traditional rehabilitation training group,the early-stage phased rehabilitation training group demonstrated a significant increase in the oxygenation index of ARDS patients[SMD=1.18,95%CI(1.01,1.35),P<0.01],with statistically significant differences.Furthermore,there were significant reductions in ICU length of stay[SMD=-0.70,95%CI(-0.90,-0.50),P<0.01],duration of mechanical ventilation[SMD=-1.15,95%CI(-1.36,-0.94),P<0.01],and occurrence of complications[OR=0.16,95%CI(0.10,0.26),P<0.01],all of which were statistically significant.[Conclusions]Early-stage phased pulmonary rehabilitation training for ARDS patients effectively improves the oxygenation index,shortens ICU length of stay and duration of mechanical ventilation,and reduces complications.These findings support the clinical application and promotion of early-stage phased rehabilitation training.
文摘目的:研究布地格福联合K5压力阈值吸气肌训练对慢阻肺急性加重期(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者呼吸力学参数及生命质量的影响。方法:选取2022年1月至2024年1月在赣州市第五人民医院就诊的80例慢阻肺急性加重期患者作为研究对象,按照随机数字表分为对照组和观察组,各40例。对照组使用布地格福进行治疗,观察组在对照组的基础上联合K5压力阈值吸气肌训练治疗,两组均治疗30d。分别比较患者治疗前后的圣乔治评分(St.George's Respiratory Questionnaire,SGRQ)、6分钟步行试验(6-minute walk test,6MWT)、最大吸气压(Maximum inspiratory pressure,MIP),并通过测量第1秒呼气量(Forced Expiratory Volume in the first second,FEV1)、用力肺活量(Forced Vital Capacity,FVC)、弥散功能血氧饱和度(Oxygen saturation of blood,SaO_(2))、动脉氧分压(Arterial Oxygen Partial Pressure,PO_(2))、动脉二氧化碳分压(Partial pressure of arterial carbon dioxide,PCO_(2))对肺功能和血气指标进行比较分析,对其进行比较分析。结果:观察组的SGRQ三项评分均低于对照组(P<0.05);治疗后观察组的6MWT和MIP两项都比对照组高(P<0.05);观察组的FEV1、FVC和弥散功能三项指标都高于对照组(P<0.05);观察组的SaO_(2)和PO_(2)明显高于对照组,PCO_(2)明显低于对照组(P<0.05)。结论:布地格福吸入气雾剂联合K5压力阈值吸气肌训练能有效减轻患者的症状,改善呼吸力学参数并提高生命质量,延长患者生存时间。
文摘目的分析呼吸训练联合无创呼吸机对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并呼吸衰竭患者呼吸功能和预后的影响。方法选取本院2016年3月至2017年3月收治的120例AECOPD合并Ⅱ型呼吸衰竭患者为研究对象。采用随机数表法将入选患者分为观察组和对照组,每组各60例,均给予综合对症治疗和无创呼吸机治疗,观察组患者在此基础上接受呼吸训练。比较两组患者治疗前后血气指标、呼吸功能、急性生理学和慢性健康状况评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、辅助呼吸肌评分,并评价患者预后、日常生活活动能力和生活质量。结果两组患者治疗后动脉血pH、动脉血氧分压(arterial partial pressure of oxygen,PaO2)、动脉血氧饱和度(arterial oxygen saturation,SaO2)均显著高于本组治疗前(均P<0.05),动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO2)均显著低于本组治疗前(均P<0.05)。治疗后24 h和72 h,观察组患者pH、PaO2、SaO2均显著高于同期对照组(均P<0.05),PaCO2均显著低于同期对照组(均P<0.05)。两组患者治疗后1周第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1与用力肺活量(forced vital capacity,FVC)比值(FEV1/FVC)、FEV1%预测值均显著高于本组治疗前(均P<0.05),APACHEⅡ评分、辅助呼吸肌评分均显著低于本组治疗前(均P<0.05)。治疗后1周,观察组患者FEV1、FEV1/FVC、FEV1%预测值均显著高于对照组(均P<0.05),APACHEⅡ评分、辅助呼吸肌评分均显著低于对照组(均P<0.05)。观察组患者住院天数、插管率均显著低于对照组(均P<0.05),两组患者病死率比较差异无统计学意义(P>0.05)。剔除病死患者后结果显示,两组患者治疗后功能独立性评定量表(functional independence measure,FIM)评分和世界卫生组织生活质量测定量表简表(brief version of WHO quality of life,WHOQOL-BREF)评分均显著高于本组治疗前(均P<0.05)。治疗后90 d和180 d,观察组患者FIM评分和WHOQOL-BREF评分均显著高于同期对照组(均P<0.05)。结论在无创呼吸机的基础上加用呼吸训练能够明显改善AECOPD合并呼吸衰竭患者的呼吸功能和预后,值得推广。
