全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
-  2017 

无创正压通气辅助踏车运动在稳定期重度慢性阻塞性肺疾病患者的实施与疗效观察

DOI: doi:10.7507/1671-6205.201702020

Keywords: 慢性阻塞性肺疾病, 肺康复, 无创正压通气, 踏车运动

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的 探讨无创正压通气(NIPPV)辅助踏车运动对稳定期重度慢性阻塞性肺疾病(简称慢阻肺)患者呼吸困难及运动耐力等的影响。 方法 研究选取 2015 年 8 月至 2016 年 1 月于我院呼吸与危重症医学科肺康复单元住院的 20 例稳定期重度慢阻肺患者。患者进行 8 周的 NIPPV 辅助踏车运动,通过自身对照方法,测定治疗前及治疗 8 周后 12 分钟步行距离、Borg 呼吸困难指数、平均肺动脉压(mPAP)、日间动脉血氧分压(PaO 2)及二氧化碳分压(PaCO 2)值,治疗前后 1 年内慢阻肺急性加重次数,并观察治疗过程中的不良反应及依从性。 结果 治疗后 12 分钟步行距离 [(810±20)m 比(680±15)m]、Borg 呼吸困难指数 [(2.4±0.1)分比(4.4±0.3)分]、mPAP [(34.4±2.7)mm Hg 比(43.5±3.8)mm Hg]、PaCO 2 [(49.8±4.9)mm Hg 比(64.3±5.2)mm Hg]、PaO 2 [(64.4±4.1)mm Hg 比(52.3±3.9)mm Hg] 均较治疗前显著改善,治疗后 1 年内慢阻肺急性加重次数也较治疗前显著减少 [(2.1±0.7)次比(4.3±2.1)次] ,差异均有统计学意义( P<0.01)。治疗不良反应为口咽干燥 2 例、胃胀气 8 例,均可以耐受。 结论 NIPPV 辅助踏车运动可提高稳定期重度慢阻肺患者的运动耐力,改善呼吸困难,提高氧合并降低 mPAP,减少 1 年内慢阻肺急性加重次数

References

[1]  2. Rabe KF, Hurd S, Anzueto A, et al. Global Initiative for Chronic Obstructive Lung Disease Global strategy for the diagnosis, management, and prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) executive summary. Am J Respir Crit Care Med, 2007, 176(6): 532-555.
[2]  3. Gershon A, Warner L, Cascagnette P, et al. Lifetime risk of developing chronic obstructive pulmonary disease: a longitudinal population study. Lancet, 2011, 378(9795): 991-996.
[3]  4. 乔翠霞, 李素云. 慢性阻塞性肺疾病的流行病学研究现状. 中国老年学杂志, 2010, 30(11): 1618-1621.0.
[4]  17. 孙楷, 聂洪玉, 刘泳,等. 肺康复对慢性阻塞性肺疾病患者运动能力和生活质量的影响. 中国呼吸与危重监护杂志, 2014, 13(5): 459-463.0.
[5]  18. Carolyn L. Rochester, Ioannis Vogiatzis, et al. An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation. Am J Respir Crit Care Med, 2015, 192(11), 1373-1386.
[6]  19. Costes F, Agresti A, Court-Fortune I, et al. Noninvasive ventilation during exercise training improves exercise tolerance in patients with chronic obstructive pulmonary disease. Cardiopulm Rehabil, 2003, 23(4): 307-313.
[7]  1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease revised 2015. Available at http://www.Gold-copd.org/guidelines-global-strategy-for-diagnosis-management.
[8]  5. Nici L, Donner C, Wouters E, et al. ATS/ERS Pulmonary Rehabilitation Writing Committee. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med, 2006, 173(12): 1390-1413.
[9]  6. Spruit MA, Singh SJ, Garvey C, et al. ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med, 2013, 188(8): e13-e64.
[10]  7. Dreher M, Waherspacher S, Sonntag F, et al. Exercise in severe COPD: is walking different from stair-climbing. Respir Med, 2008, 102(6):912-918.
[11]  8. Borghi-Silva A, Mendes RG, Toledo AC, et al. Adjuncts to physical training of patients with severe COPD: oxygen or noninvasive ventilation? Respir Care, 2010, 55(7):885-894.
[12]  9. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南(2013 年修订版). 中华结核和呼吸杂志, 2013, 36(4).1-12.0.
[13]  10. Corner E, Garred R. Does the addition of non-invasive ventilation during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease augment patient outcome in exercise tolerance? A literature review. Physiother Res Int, 2010, 15(1):5-15.
[14]  12. Mador MJ, Rodis A, Magaiang UJ. Reproducibility of berg scale measurement of dyspnoea during exercise in patients with COPD. Chest, 1995, 107(6): 1590-1597.
[15]  13. Bambi S. Noninvasive positive pressure ventilation: an ABC approach for advanced nursing in emergency departments and acute care settings. Dimens Crit Care Nuts, 2009, 28(6): 253-263.
[16]  14. Bianchi L, Foglio K, Porta R.et al.Lack of additional effect of adjunct of assisted ventilation to pulmonary rehabilitation in mild COPD patients. Respir Med, 2002, 96(5):359-367.
[17]  15. 李群, 陈锋, 王晓霞, 等. 肺康复训练对不同严重度稳定期慢性阻塞性肺疾病的影响. 中国呼吸与危重监护杂志, 2013, 12(2): 130-135.0.
[18]  16. 孟志刚, 佘瑞芳, 姚彬. 持续肺康复训练对保持 COPD 患者肺康复治疗后运动能力和生活质量的影响. 中国呼吸与危重监护杂志, 2010, 9(2): 133-136.0.
[19]  11. Mc Gavin CR, Gupta SP, Mc Hardy GJ. Twelve-minutes walking test for assessing disability in chronic bronchitis. Br Med J, 1976, 1(6013): 822-823.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133