国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2009年
11期
662-665
,共4页
慢性阻塞性肺疾病%运动%无创通气%康复
慢性阻塞性肺疾病%運動%無創通氣%康複
만성조새성폐질병%운동%무창통기%강복
Chronic obstructive pulmonary disease%Exercise%Noninvasive ventilation%Rehabilitation
目的 探讨踏车运动锻炼结合面罩双水平气道正压(bi-level positive airway pressure,BiPAP)无创通气对稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的康复作用.方法 选择稳定期COPD患者30例,随机分为治疗组和对照组.两组患者测定肺功能,基础呼吸困难指数(basic dyspnea index,BDI),12分钟步行距离(twelve minutes walking distance,12MWD),呼吸肌力量,包括最大吸气压(maximal inspiratory pressure,Plmax)和最大跨膈肌压(maximal transdiaphragmatic pressure,Pdimax),自行车运动耐力等参数.治疗组患者在踏车上运动锻炼的同时接受面罩BiPAP通气,运动负荷为其自行车运动最大负荷的75%.每天锻炼2 h,每周5 d,连续4周.对照组不接受治疗.4周后两组患者均复查上述参数.结果 4周后.治疗组患者肺功能中的深吸气量(inspiratory capacity,IC)明显增加,变化呼吸困难指数(transition dyspnea index,TDI)与对照组比较显著改善(6.3±1.5 vs 2.8±1.3,P<0.05).12MWD增加[治疗前(784±19)m vs治疗后(928±15)m,P<0.01].呼吸肌肉力量增强,Plmax从(56±12)cm H2O上升到(78±10)cm H2O(P<0.01),Pdimax则从(80±13)cm H2O上升到(112±18)cm H2O(P<0.01).自行车运动耐力时间延长[(212±31)s vs(395±29)s,P<0.053],最大运动功率增加[(45±13)W vs(77±12)W,P<0.05],结论稳定期COPD患者在踏车上进行面罩无创通气运动锻炼有助于改善其呼吸肌肉力量,增加IC,缓解呼吸困难,提高运动耐力.
目的 探討踏車運動鍛煉結閤麵罩雙水平氣道正壓(bi-level positive airway pressure,BiPAP)無創通氣對穩定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的康複作用.方法 選擇穩定期COPD患者30例,隨機分為治療組和對照組.兩組患者測定肺功能,基礎呼吸睏難指數(basic dyspnea index,BDI),12分鐘步行距離(twelve minutes walking distance,12MWD),呼吸肌力量,包括最大吸氣壓(maximal inspiratory pressure,Plmax)和最大跨膈肌壓(maximal transdiaphragmatic pressure,Pdimax),自行車運動耐力等參數.治療組患者在踏車上運動鍛煉的同時接受麵罩BiPAP通氣,運動負荷為其自行車運動最大負荷的75%.每天鍛煉2 h,每週5 d,連續4週.對照組不接受治療.4週後兩組患者均複查上述參數.結果 4週後.治療組患者肺功能中的深吸氣量(inspiratory capacity,IC)明顯增加,變化呼吸睏難指數(transition dyspnea index,TDI)與對照組比較顯著改善(6.3±1.5 vs 2.8±1.3,P<0.05).12MWD增加[治療前(784±19)m vs治療後(928±15)m,P<0.01].呼吸肌肉力量增彊,Plmax從(56±12)cm H2O上升到(78±10)cm H2O(P<0.01),Pdimax則從(80±13)cm H2O上升到(112±18)cm H2O(P<0.01).自行車運動耐力時間延長[(212±31)s vs(395±29)s,P<0.053],最大運動功率增加[(45±13)W vs(77±12)W,P<0.05],結論穩定期COPD患者在踏車上進行麵罩無創通氣運動鍛煉有助于改善其呼吸肌肉力量,增加IC,緩解呼吸睏難,提高運動耐力.
목적 탐토답차운동단련결합면조쌍수평기도정압(bi-level positive airway pressure,BiPAP)무창통기대은정기만성조새성폐질병(chronic obstructive pulmonary disease,COPD)환자적강복작용.방법 선택은정기COPD환자30례,수궤분위치료조화대조조.량조환자측정폐공능,기출호흡곤난지수(basic dyspnea index,BDI),12분종보행거리(twelve minutes walking distance,12MWD),호흡기역량,포괄최대흡기압(maximal inspiratory pressure,Plmax)화최대과격기압(maximal transdiaphragmatic pressure,Pdimax),자행차운동내력등삼수.치료조환자재답차상운동단련적동시접수면조BiPAP통기,운동부하위기자행차운동최대부하적75%.매천단련2 h,매주5 d,련속4주.대조조불접수치료.4주후량조환자균복사상술삼수.결과 4주후.치료조환자폐공능중적심흡기량(inspiratory capacity,IC)명현증가,변화호흡곤난지수(transition dyspnea index,TDI)여대조조비교현저개선(6.3±1.5 vs 2.8±1.3,P<0.05).12MWD증가[치료전(784±19)m vs치료후(928±15)m,P<0.01].호흡기육역량증강,Plmax종(56±12)cm H2O상승도(78±10)cm H2O(P<0.01),Pdimax칙종(80±13)cm H2O상승도(112±18)cm H2O(P<0.01).자행차운동내력시간연장[(212±31)s vs(395±29)s,P<0.053],최대운동공솔증가[(45±13)W vs(77±12)W,P<0.05],결론은정기COPD환자재답차상진행면조무창통기운동단련유조우개선기호흡기육역량,증가IC,완해호흡곤난,제고운동내력.
Objective To investigate the rehabilitional effects of mask noninvasive airway positive ventilation during treadmill exercise in stable patients with chronic obstructive pulmonary disease(COPD). Methods Thirty patients with stable COPD were selected and were randomly divided into two groups: management group and control group. The following parameters were measured:lung function, dyspnea index (measured with Mahler method), twelve minutes walking distance (12MWD), the functions of respiratory muscle which included maximal inspiratory pressure (Plmax) and maximal transdiaphragmatic pressure (Pdimax), exercise endurance. Patients in management group received mask noninvasive airway positive ventilation during treadmill exercise at 75% of the previously maximal load (Wmax). This management was carried out two hours per day,five days each week for 4 consecutive weeks. Patents in control group received placebo management. The above parameters were measured again four weeks later in both groups. Results Four weeks later, the following parameters in management group improved more significantly than those before treatment:inspiratorycapacity (IC),12MWD [from (784±19) m to (928±15) m, P<0. 01],Plmax [from (56±12) cm H2O to (78±10) cm H2O, P<0.01],Pdimax [from (80±13) cm H2O to (112±18) cm H2O, P<0.01],exerciseendurance time [from (212±31) s to (395±29) s, P<0.05] and Wmax[from (45±13) W to (77±12) W, P<0.05]. Dyspnea (measured by transition dyspnea index,TDI) in management group also improved better significantly than that of control group (6.3±1.5 vs 2.8±1.3, P< 0.05). Conclusions Mask noninvasive airway positive ventilation during treadmill exercise has the effects of improving the strength of respiratory muscle and dyspnea,increasing IC,and enhancing exercise endurance in stable patients with COPD.
