国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2010年
21期
1290-1293
,共4页
刘海涛%何敬堂%李志娟%赵梅星%李红%张景%汪涛
劉海濤%何敬堂%李誌娟%趙梅星%李紅%張景%汪濤
류해도%하경당%리지연%조매성%리홍%장경%왕도
肺疾病,慢性阻塞性%无创正压机械通气%家庭机械通气%呼吸功能不全%高碳酸血症%呼吸锻炼
肺疾病,慢性阻塞性%無創正壓機械通氣%傢庭機械通氣%呼吸功能不全%高碳痠血癥%呼吸鍛煉
폐질병,만성조새성%무창정압궤계통기%가정궤계통기%호흡공능불전%고탄산혈증%호흡단련
Pulmonary disease,chronic obstructive%Noninvasive positive pressure ventilation%Home mechanical ventilation%Respiratory insufficiency%Hypercapnia%Breathing exercises
目的 探索与评估家庭无创正压机械通气(HNPPV)联合呼吸操对稳定期重度慢性阻塞性肺疾病(COPD)患者的疗效.方法 将56例经住院治疗处于稳定期的重度COPD患者分为呼吸操+HNPPV组(治疗组)26例和无创呼吸机组(对照组)30例.分别记录治疗前、治疗后2年两组患者的动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、肺功能、6分钟行走距离(6MWD)、呼吸困难分级、辅助呼吸肌评分、年住院次数及病死率等指标.结果 治疗前治疗组与对照组的年龄、性别、COPD病程、体质量指数、PaCO2、PaO2、第1秒用力呼气容积占预计值百分比(FEV1%pred)、第1秒用力呼气容积占用力肺活量比值(FEV1/FVC%)、6MWD、呼吸困难分级、辅助呼吸肌评分、每年住院次数均具有可比性.2年后治疗组呼吸困难分级、辅助呼吸肌评分、6MWD、每年住院次数,优于对照组[(1.76±0.52)分vs(2.09±0.57)分、(2.44±0.62)分vs(2.96±0.58)分、(262.64±32.98)m vs(244.25±25.83)m、(2.06±0.85)次/年vs(2.62±0.92)次/年],差异均具有统计学意义(P值均＜0.05),治疗组死亡1例(1/26),对照组死亡2例(2/30),两组病死率比较差异无统计学意义(x2=0.02).结论 长期应用HNPPV联合呼吸操锻炼对稳定期重度COPD患者的康复更加有效.
目的 探索與評估傢庭無創正壓機械通氣(HNPPV)聯閤呼吸操對穩定期重度慢性阻塞性肺疾病(COPD)患者的療效.方法 將56例經住院治療處于穩定期的重度COPD患者分為呼吸操+HNPPV組(治療組)26例和無創呼吸機組(對照組)30例.分彆記錄治療前、治療後2年兩組患者的動脈血氧分壓(PaO2)、動脈血二氧化碳分壓(PaCO2)、肺功能、6分鐘行走距離(6MWD)、呼吸睏難分級、輔助呼吸肌評分、年住院次數及病死率等指標.結果 治療前治療組與對照組的年齡、性彆、COPD病程、體質量指數、PaCO2、PaO2、第1秒用力呼氣容積佔預計值百分比(FEV1%pred)、第1秒用力呼氣容積佔用力肺活量比值(FEV1/FVC%)、6MWD、呼吸睏難分級、輔助呼吸肌評分、每年住院次數均具有可比性.2年後治療組呼吸睏難分級、輔助呼吸肌評分、6MWD、每年住院次數,優于對照組[(1.76±0.52)分vs(2.09±0.57)分、(2.44±0.62)分vs(2.96±0.58)分、(262.64±32.98)m vs(244.25±25.83)m、(2.06±0.85)次/年vs(2.62±0.92)次/年],差異均具有統計學意義(P值均＜0.05),治療組死亡1例(1/26),對照組死亡2例(2/30),兩組病死率比較差異無統計學意義(x2=0.02).結論 長期應用HNPPV聯閤呼吸操鍛煉對穩定期重度COPD患者的康複更加有效.
목적 탐색여평고가정무창정압궤계통기(HNPPV)연합호흡조대은정기중도만성조새성폐질병(COPD)환자적료효.방법 장56례경주원치료처우은정기적중도COPD환자분위호흡조+HNPPV조(치료조)26례화무창호흡궤조(대조조)30례.분별기록치료전、치료후2년량조환자적동맥혈양분압(PaO2)、동맥혈이양화탄분압(PaCO2)、폐공능、6분종행주거리(6MWD)、호흡곤난분급、보조호흡기평분、년주원차수급병사솔등지표.결과 치료전치료조여대조조적년령、성별、COPD병정、체질량지수、PaCO2、PaO2、제1초용력호기용적점예계치백분비(FEV1%pred)、제1초용력호기용적점용력폐활량비치(FEV1/FVC%)、6MWD、호흡곤난분급、보조호흡기평분、매년주원차수균구유가비성.2년후치료조호흡곤난분급、보조호흡기평분、6MWD、매년주원차수,우우대조조[(1.76±0.52)분vs(2.09±0.57)분、(2.44±0.62)분vs(2.96±0.58)분、(262.64±32.98)m vs(244.25±25.83)m、(2.06±0.85)차/년vs(2.62±0.92)차/년],차이균구유통계학의의(P치균＜0.05),치료조사망1례(1/26),대조조사망2례(2/30),량조병사솔비교차이무통계학의의(x2=0.02).결론 장기응용HNPPV연합호흡조단련대은정기중도COPD환자적강복경가유효.
Objective To study the effects of home noninvasive positive pressure ventilation (HNPPV) plus breathing exercises actualized on the patients with stable severe chronic obstructive pulmonary disease (COPD). Methods Fifty-six patients with stable severe COPD after hospital discharge were randomized divided into 2 groups: the therapy group (n = 26) with breathing exercises and HNPPV,and the control group ( n = 30) with HNPPV. Parameters before and after 2 year follow up observation were compared, which included arterial partial pressure of carbon dioxide (PaCO2), pulmonary function,6-min walking distance (6MWD), dyspnea grade, scale for accessory muscle use, hospitalization rates and mortality. Results The age,gender, course of disease, body mass index, arterial PaCO2, PaO2,forced expiratory volume in one second ( FEV1 % pred), FEV1/FVC%, 6MWD, dyspnea grade, scale for accessory muscle use,and hospitalization rates of the 2 groups were similar. After 2 years,the difference of dyspnea grade,scale for accessory muscle use,6MWD and hospitalization rates in the therapy group was statistically significant compared to the control group[(1. 76±0.52) vs (2.09±0. 57)、(2. 44±0.62) vs(2.96±0.58) 、(262.64±32.98) m vs (244. 25±25.83) m、(2.06±0.85) times/year vs (2.62±0.92)times/year] (all P ＜ 0.05). The mortality had no statistically significant difference (1/26, 2/30,respectively, x 2 = 0.02). Conclusions HNPPV plus breathing exercises with stable severe COPD is effective and safe.
