400038 重庆,陆军军医大学(第三军医大学)第一附属医院老年医学和特勤医学科
Received:23 March 2019,
Revised:2019-06-27,
Published:30 September 2019
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Chenchen ZHANG, Linglin LIU, Shuangshuang SONG, et al. Efficacy of different physiotherapies for pulmonary rehabilitation in patients with acute exacerbation of severe chronic obstructive pulmonary disease[J]. Journal of Third Military Medical University, 2019, 41(18): 1782-1788.
Chenchen ZHANG, Linglin LIU, Shuangshuang SONG, et al. Efficacy of different physiotherapies for pulmonary rehabilitation in patients with acute exacerbation of severe chronic obstructive pulmonary disease[J]. Journal of Third Military Medical University, 2019, 41(18): 1782-1788. DOI: 10.16016/j.1000-5404.201903196.
目的
2
观察不同物理疗法对重度慢性阻塞性肺部疾病急性加重期(acute exacerbation of chronic obstructive pulmonary diseases,AECOPD)患者肺康复的效果。
方法
2
纳入2016年1月至2018年9月本院内科收治的68例重度AECOPD患者,均进行常规药物治疗,通过随机分配分为对照组(
n
=20,仅采用常规治疗,不接受任何呼吸以及排痰辅助治疗)、高频胸壁振荡排痰系统(high-frequency chest wall oscillation system expectoration,HFCWO)治疗组(
n
=24,在常规治疗基础上接受HFCWO治疗)和开放声门侧体位呼气(expiration with the glottis open in the lateral posture
ELTGOL)治疗组(
n
=24,在常规治疗基础上接受ELTGOL治疗)。患者均干预2周,观察和评估3组患者干预前后的肺功能指标、血气相关指标、临床症状评分、住院时间、生活质量评分的变化。
结果
2
治疗后,HFCWO组和ELTGOL组患者的PEF、FVC、FEV1、FEV1/FVC均高于对照组(
P
<
0.05);HFCWO组和ELTGOL组患者的PaO
2
高于对照组,PaCO
2
小于对照组(
P
<
0.05);HFCWO组和ELTGOL组患者的咳嗽评分、咳痰评分、喘息评分、哮鸣评分、气短评分等临床症状评分明显低于对照组(
P
<
0.05);HFCWO组和ELTGOL组患者的咳痰好转时间和住院时间短于对照组(
P
<
0.05);HFCWO组和ELTGOL组患者的生活治疗中的症状评分、活动评分、影响评分和总评分均低于对照组(
P
<
0.05),HFCWO组患者的症状评分、活动评分、影响评分和总评分均低于ELTGOL组(
P
<
0.05)。3组患者对治疗的耐受性比较差异无统计学意义(
P
>
0.05)。
结论
2
HFCWO和ELTGOL均能有效改善对重度AECOPD患者的肺功能和血气水平,但HFCWO治疗效果更佳。
Objective
2
To assess the effect of different physical therapies for pulmonary rehabilitation in patients with acute exacerbation of severe chronic obstructive pulmonary diseases (AECOPD).
Methods
2
Between January
2016 and September
2018
a total of 68 inpatients with AECOPD were randomized for treatment with high-frequency chest wall oscillation (HFCWO group
n
=24)
expiration with the glottis open in the lateral posture (ELTGOL group
n
=24)
or routine treatment without assisted ventilation or expectoration (control group
n
=20). All the patients were given routine medications in addition to the specified treatments for 2 weeks
and the changes in the pulmonary function indexes
blood gas parameters
clinical symptom scores
hospital stay and the quality of life scores were assessed after the treatments.
Results
2
Compared with those in the control group
the patients in both the HFCWO group and ELTGOL group showed significant improvements in pulmonary function indexes and blood gas parameters (
P
<
0.05) with significantly reduced clinical symptom scores (
P
<
0.05) after the treatments. The quality of life score was also significantly improved after the treatments in HFCWO and ELTGOL groups (
P
<
0.05)
which had significantly shorter hospital stay compared than the control group (
P
<
0.05). These improvements were significantly more obvious in HFCWO group than in ELTGOL group.
Conclusion
2
Both HFCWO and ELTGOL can effectively improve the pulmonary function and blood gas parameters in patients with severe AECOPD
but HFCWO can produce better therapeutic effect than ELTGOL.
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