充分氧合下综合肺康复治疗对老年COPD稳定期患者的临床疗效评价

doi:10.3969/j.issn.1004-583X.2021.02.008

摘要/Abstract

摘要：

目的评价老年慢性阻塞性肺疾病(COPD)稳定期患者在充分氧合下的综合性肺康复治疗的临床疗效。方法 2019年1月至2019年8月本院老年病科接诊的65岁及以上稳定期老年COPD患者52例,随机分为观察组和对照组各26例。其中对照组给予常规传统性治疗,观察组在对照组常规治疗基础上给予充分氧合下的综合肺康复治疗。比较两组患者治疗前、治疗3个月后呼吸困难程度评分、6 min步行试验距离(6MWD)、肺功能、动脉血气分析、心率(HR)、血氧饱和度(SaO₂)的差异。结果治疗3月后观察组患者6MWD、改良英国医学研究委员会呼吸困难量表(mMRC)评分,SaO₂均明显优于治疗前及对照组(P<0.01),动脉血二氧化碳分压(PaCO₂)、动脉血氧分压(PaO₂)、第一秒用力呼吸容积占预计值百分比(FEV₁%)、中期呼气流速(FEF25%~75%)均较治疗前及对照组有所改善(P<0.05)。结论充分氧合下的综合肺康复治疗可有效改善稳定期老年COPD患者肺功能,纠正二氧化碳潴留,缓解呼吸困难症状,提高患者生活质量。

关键词: 肺疾病, 慢性阻塞性, 血气分析, 氧, 康复

Abstract:

Objective To evaluate the clinical efficacy of comprehensive pulmonary rehabilitation therapy with sufficient oxygenation in senile patients with chronic obstructive pulmonary disease(COPD) at stable stage. Methods A total of 52 patients with COPD aged 65 years or over who were admitted to the department of geriatrics of our hospital from January 2019 to August 2019 were randomly divided into observation group and control group with 26 cases in each group. The control group was given conventional therapy, and the observation group received comprehensive pulmonary rehabilitation therapy with sufficient oxygenation on the basis of conventional treatment in the control group. British Medical Research Council Dyspnea scale (mMRC) score, 6 min walking distance(6MWD), lung function, arterial blood gas analysis, heart rate (HR), and blood oxygen saturation (SaO₂) were compared before treatment and 3 months after treatment in two groups. Results 6MWD, mMRC score, and SaO₂ in observation group were significantly better after 3 months of treatment than before treatment and control group (P<0.01). Partial arterial blood carbon dioxide pressure (PaCO₂), partial oxygen pressure (PaO₂), the percentage of forced breathing volume in the first second (FEV1%), and middle expiratory flow rate (FEF25%-75%) were all improved after 3 months of treatment as compared with before treatment and control group (P<0.05). Conclusion Comprehensive pulmonary rehabilitation therapy with sufficient oxygenation can effectively improve the lung function of senile patients with COPD at stable stage, correct carbon dioxide retention, relieve dyspnea symptoms, and improve the quality of life of senile patients.

Key words: pulmonary disease, chronic obstructive, blood gas analysis, oxygen, rehabilitation

中图分类号:

R563

夏晓黎, 马艳萍, 王亚锋. 充分氧合下综合肺康复治疗对老年COPD稳定期患者的临床疗效评价[J]. 临床荟萃, 2021, 36(2): 134-138.

Xia Xiaoli, Ma Yanping, Wang Yafeng. Clinical efficacy of comprehensive pulmonary rehabilitation therapy with full oxygenation in senile patients with COPD at stable stage[J]. Clinical Focus, 2021, 36(2): 134-138.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.02.008

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I2/134

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参考文献 22

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组别	例数	FEV₁%		FEF25%~75%		FEV₁/FVC(%)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	26	29.0±5.4	28.3±5.7	46.8±5.4	49.2±7.4	63.9±7.5	62.8±9.5
观察组	26	30.6±7.4	34.2±6.2^*	45.2±9.3	52.1±7.6^*	62.8±8.5	66.8±10.5
t值		0.323	3.572	0.333	3.453	0.531	0.386
P值		>0.05	<0.01	>0.05	<0.05	>0.05	>0.05

组别	例数	FEV₁%		FEF25%~75%		FEV₁/FVC(%)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	26	29.0±5.4	28.3±5.7	46.8±5.4	49.2±7.4	63.9±7.5	62.8±9.5
观察组	26	30.6±7.4	34.2±6.2^*	45.2±9.3	52.1±7.6^*	62.8±8.5	66.8±10.5
t值		0.323	3.572	0.333	3.453	0.531	0.386
P值		>0.05	<0.01	>0.05	<0.05	>0.05	>0.05

组别	例数	6MWT(m)		mMRC(分)
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	26	192.5±47.2	164.3±37.5	51.2±12.3	49.8±13.7
观察组	26	212.1±41.2	248.0±26.7^*	58.3±13.3	41.3±15.4^*
t值		2.057	-3.184	0.554	4.377
P值		>0.05	<0.01	>0.05	<0.01

组别	例数	6MWT(m)		mMRC(分)
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	26	192.5±47.2	164.3±37.5	51.2±12.3	49.8±13.7
观察组	26	212.1±41.2	248.0±26.7^*	58.3±13.3	41.3±15.4^*
t值		2.057	-3.184	0.554	4.377
P值		>0.05	<0.01	>0.05	<0.01

组别	例数	PaO₂(mmHg)		PaCO₂(mmHg)
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	26	53.8±5.2	61.3±7.0	68.9±3.7	65.8±3.3
观察组	26	54.0±5.8	70.6±6.8^*	67.1±4.1	61.1±4.3^*
t值		0.147	7.658	0.241	9.321
P值		>0.05	<0.05	>0.05	<0.05