吸气肌功能训练对慢性阻塞性肺疾病急性加重期患者的影响

Effect of inspiratory muscle function training for patients with acute exacerbation of chronic obstructive pulmonary disease

  • 摘要: 目的 探讨吸气肌功能训练对慢性阻塞性肺疾病急性加重期(AECOPD)患者肺功能及血气分析指标的影响。 方法 将125例AECOPD患者随机分为观察组(n=63)和对照组(n=64)。对照组给予重症监护室基础管理,观察组在对照组基础上给予吸气肌功能训练。观察2组肺功能、血气分析指标、机械通气时间和呼吸机相关性肺炎发生率。 结果 训练后,观察组用力呼气时呼出的最大气量(FVC)、第1秒用力呼气容积(FEV1)、吸气峰流速(PIF)、最大通气量(MVV)、最大吸气压(MIP)水平均高于对照组,差异有统计学意义(P<0.05)。观察组动脉血氧分压[pa(O2)]水平高于对照组,动脉血二氧化碳分压[pa(CO2)]水平低于对照组,机械通气时间短于对照组,差异有统计学意义(P<0.05)。观察组呼吸机相关性肺炎发生率为3.17%, 低于对照组的16.39%, 差异有统计学意义(P<0.05)。 结论 吸气肌功能训练可增强重症监护室AECOPD患者吸气肌肌力和耐力,改善肺功能和血气水平,缩短机械通气时间,降低呼吸机相关性肺炎发生率。

     

    Abstract: Objective To investigate the effect of inspiratory muscle training on lung function and blood gas analysis indexes in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 125 AECOPD patients were randomly divided into observation group(n=63)and control group(n=64). The control group was given basic management in the intensive care unit, and the observation group was given inspiratory muscle function training on the basis of the control group. Lung function, blood gas analysis index, mechanical ventilation time and the incidence of ventilator-associated pneumonia were observed in the two groups. Results After training, the levels of forced vital capacity(FVC), forced expiratory volume in one second(FEV1), peak inspiratory flow(PIF), maximal voluntary ventilation(MVV)and maximal inspiratory pressure(MIP)in the observation group were significantly higher than those in the control group(P<0.05). The arterial partial pressure of oxygen [pa(O2)] level of the observation group was significantly higher, the arterial partial pressure of carbon dioxide[pa(CO2)] level was significantly lower, and the mechanical ventilation time was significantly shorter than that of the control group(P<0.05). The incidence of ventilator associated pneumonia in the observation group was significantly lower than that in the control group(3.17% versus 16.39%, P<0.05). Conclusion Inspiratory muscle training can enhance inspiratory muscle strength and endurance, improve lung function and blood gas level, shorten mechanical ventilation time, and reduce the incidence of ventilator-associated pneumonia of patients with AECOPD in intensive care unit.

     

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