天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (5): 498-502.doi: 10.11958/20212368

• 临床研究 • 上一篇    下一篇

体外膈肌起搏器联合呼吸训练器对稳定期COPD合并Ⅱ型呼吸衰竭患者的临床疗效观察#br#

王亚锋1，夏晓黎2△，马艳萍2，张宁1，魏才杰1，马娇娇1   

  1. 1甘肃中医药大学（邮编730000）；2甘肃中医药大学附属医院
  • 收稿日期:2021-10-21 修回日期:2022-01-17 出版日期:2022-05-15 发布日期:2022-07-04
  • 基金资助:
    甘肃省中医药管理局科研项目（GZK-2019-33）；兰州市科技发展指导性计划项目（2020-ZD-63）

Clinical observation of external diaphragm pacemaker combined with breathing exerciser in patients with stable COPD and type Ⅱ respiratory failure

WANG Yafeng1, XIA Xiaoli2△, MA Yanping2, ZHANG Ning1, WEI Caijie1, MA Jiaojiao1   

  1. 1 Gansu University of Chinese Medicine, Gansu 730000, China; 2 the Affiliated Hospital of Gansu University of Chinese Medicine
  • Received:2021-10-21 Revised:2022-01-17 Published:2022-05-15 Online:2022-07-04

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摘要： 目的　观察体外膈肌起搏器（EDP）联合呼吸训练器对稳定期慢性阻塞性肺疾病（COPD）合并Ⅱ型呼吸衰竭患者的临床疗效。方法　纳入稳定期COPD合并Ⅱ型呼吸衰竭患者82例，按照随机数字表法分为呼吸器组（27例）、EDP组（26例）和联合组（29例）。各组按指南给予基础治疗并给予腹部顶沙袋训练、阻力单车训练，呼吸器组加用呼吸训练器，EDP组联用EDP治疗，联合组给予EDP联合呼吸训练器治疗，疗程10周。观察各组治疗前后血气分析、肺功能、运动能力和症状评分。结果　组内比较：各组治疗后较治疗前第1秒呼气容积占预计值百分比（FEV1%）、用力肺活量（FVC）、第1秒呼气容积与用力肺活量比值（FEV1/FVC%）、动脉血氧分压［p（O2）］、6分钟步行试验（6MWT）增加，动脉血二氧化碳分压［p（CO2）］、改良英国医学研究委员会呼吸困难量表（mMRC）评分、慢性阻塞性肺疾病评估测试（CAT）评分减小（P＜0.05）；最大呼气中段流量占预计值百分比（MMF%）、动脉血氧饱和度（SaO2）、动脉血酸度（pH值）、碳酸氢根（HCO3-）、碱剩余（BE）差异无统计学意义（P＞0.05）。组间比较：治疗后联合组较呼吸器组和EDP组FEV1%、FVC、FEV1/FVC%、p（O2）、6MWT增加，p（CO2）、CAT、mMRC评分减小（P＜0.05）；MMF%、SaO2、pH值、HCO3-、BE差异无统计学意义（P＞0.05）。结论　EDP联合呼吸训练器能够改善稳定期COPD合并Ⅱ型呼吸衰竭患者的肺功能指标及缺氧状态，提高患者运动能力，减轻呼吸困难等症状，值得临床应用。

关键词: 肺疾病, 慢性阻塞性；呼吸功能不全；呼吸功能试验；体外膈肌起搏器；呼吸训练器

Abstract: Objective　To observe the clinical effect of external diaphragm pacemaker (EDP) combined with respiratory trainer in patients with stable chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure. Methods　A total of 82 patients with stable COPD complicated with type Ⅱ respiratory failure were enrolled and divided into the ventilator group (27 cases), the EDP group (26 cases) and the combined group (29 cases) according to the random number table method. Each group was given basic treatment according to the guidelines, abdominal top sandbag training and resistance cycling training. Breathing apparatus was added to the respirator group. The EDP group was given EDP treatment, and the combination group was given EDP combined with a breathing trainer for 10 weeks. Pulmonary function, blood gas analysis, exercise capacity and symptom scores were observed before and after treatment in each group. Results　FEV1%, FVC, FEV1/FVC%, p(O2) and 6MWT increased significantly, and p(CO2), mMRC and CAT decreased significantly before treatment in each group (P＜0.05). There were no significant differences in MMF%, SaO2, pH, HCO3- and BE between the groups (P＞0.05). After treatment, FEV1%, FVC, FEV1/FVC%, p(O2) and 6MWT significantly increased, and p(CO2), mMRC, CAT significantly decreased in the combined group than those of the ventilator group (P＜0.05). There were no significant differences in MMF%, SaO2, pH, HCO3- and BE between the groups (P＞0.05). Conclusion　EDP combined with breathing trainer can improve the pulmonary function index and hypoxia state of patients with stable COPD combined with type Ⅱ respiratory failure, improve exercise ability and relieve symptoms such as dyspnea, which is worthy of clinical application.

Key words: pulmonary disease, chronic obstructive, respiratory insufficiency, respiratory function tests, external diaphragm pacemaker, breathing training device

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