不同物理疗法对重度慢性阻塞性肺疾病急性加重期患者肺康复效果的影响

章陈晨; 刘凌琳; 宋双双; 熊玮

doi:10.16016/j.1000-5404.201903196

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不同物理疗法对重度慢性阻塞性肺疾病急性加重期患者肺康复效果的影响

临床医学 | 更新时间：2026-01-09

- 不同物理疗法对重度慢性阻塞性肺疾病急性加重期患者肺康复效果的影响
- Efficacy of different physiotherapies for pulmonary rehabilitation in patients with acute exacerbation of severe chronic obstructive pulmonary disease
- 第三军医大学学报 2019年41卷第18期页码：1782-1788
- 作者机构：
  
  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
- 作者简介：
  
  [ 熊玮，E-mail:xiongwei64@126.com XIONG Wei, E-mail: xiongwei64@126.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201903196
  中图分类号： R181.32;R454;R563.805
- 收稿：2019-03-23，
  
  修回：2019-06-27，
  
  纸质出版：2019-09-30
- 稿件说明：
移动端阅览
章陈晨, 刘凌琳, 宋双双, 等. 不同物理疗法对重度慢性阻塞性肺疾病急性加重期患者肺康复效果的影响[J]. 第三军医大学学报, 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.
章陈晨, 刘凌琳, 宋双双, 等. 不同物理疗法对重度慢性阻塞性肺疾病急性加重期患者肺康复效果的影响[J]. 第三军医大学学报, 2019,41(18):1782-1788. DOI： 10.16016/j.1000-5404.201903196.

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.

摘要

目的

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

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(

=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(

=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(

=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

治疗后，HFCWO组和ELTGOL组患者的PEF、FVC、FEV1、FEV1/FVC均高于对照组(

0.05)；HFCWO组和ELTGOL组患者的PaO

高于对照组，PaCO

小于对照组(

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(

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(

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(

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(

0.05)。3组患者对治疗的耐受性比较差异无统计学意义(

0.05)。

结论

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。

Abstract

Objective

To assess the effect of different physical therapies for pulmonary rehabilitation in patients with acute exacerbation of severe chronic obstructive pulmonary diseases (AECOPD).

Methods

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

=24)

expiration with the glottis open in the lateral posture (ELTGOL group

=24)

or routine treatment without assisted ventilation or expectoration (control group

=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

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 (

0.05) with significantly reduced clinical symptom scores (

0.05) after the treatments. The quality of life score was also significantly improved after the treatments in HFCWO and ELTGOL groups (

0.05)

which had significantly shorter hospital stay compared than the control group (

0.05). These improvements were significantly more obvious in HFCWO group than in ELTGOL group.

Conclusion

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.

关键词

Keywords

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