摘要
目的 评估早期肺康复联合无创呼吸机对中重度慢性阻塞性肺疾病(COPD)患者肺功能和生活质量的影响.方法 选择2022年4-10月中卫市人民医院诊治的86例COPD患者作为研究对象,选择其中接受无创呼吸机联合肺康复治疗的 43 例患者作为观察组,根据组间基线资料均衡可比的原则,另外选择单纯接受无创呼吸机治疗的 43 例患者作为对照组.持续治疗 3 个月后,对比两组患者临床疗效、肺功能[第 1 秒用力呼气容积(FEV1)及与第 1 秒用力呼气容积呼气量占用力肺活量(FVC)比值(FEV1/FVC)]、生活质量[COPD评估测试(CAT)评估]、运动耐力[6 分钟步行测试(6MWT)和修订后的医学研究理事会呼吸困难评分(mMRC)]及炎症因子[C-反应蛋白(CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子α(TNF-α)]水平.结果 治疗前,两组患者肺功能(FEV1、FEV1/FVC)、生活质量(CAT)、运动耐力(6MWT、mMRC)、炎症因子(CRP、IL-6、TNF-α)水平比较,差异均无统计学意义(P>0.05).治疗3个月后,两组患者FEV1、FEV1/FVC、6MWT均升高,且观察组高于对照组,差异有统计学意义(P<0.05);CAT、mMRC及各项炎症因子水平均下降,且观察组低于对照组,差异有统计学意义(P<0.05).观察组患者的临床总有效率为 95.35%,高于对照组的81.40%,差异有统计学意义(P<0.05).结论 无创呼吸机联合肺康复方案对中重度COPD患者的肺功能和生活质量具有改善作用,并可降低炎症因子水平,提高患者的运动耐力.
Abstract
Objective To evaluate the effects of early pulmonary rehabilitation combined with non-invasive ventilators on lung function and quality of life in patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods Eighty-six COPD patients treated at Zhongwei People's Hospital from April to October 2022 were selected as the research subjects.Among them,43 patients who received non-invasive ventilator combined with pulmonary rehabilitation treatment were selected as the observation group.According to the principle of balanced and comparable baseline data between groups,another 43 patients who received non-invasive ventilator treatment alone were selected as the control group.After 3 months of continuous treatment,the clinical efficacy,lung function[First second forced expiratory volume(FEV1)and its ratio to forced vital capacity(FEV1/FVC)],quality of life[COPD assessment test(CAT)evaluation],exercise endurance[6-minute walking distance(6MWT)and modified Medical Research Council Muscle Strength Scale(mMRC)],and levels of inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor alpha(TNF-α)]were compared between the two groups of patients.Results Before treatment,there was no statistically significant difference in lung function(FEV1,FEV1/FVC),quality of life(CAT),exercise endurance(6MWT,mMRC),and levels of inflammatory factors(CRP,IL-6,TNF-α)between the two groups(P>0.05).After 3 months of treatment,FEV1,FEV1/FVC,and 6MWT increased in both groups of patients,and the observation group was higher than the control group,with statistical significance(P<0.05).The levels of CAT,mMRC,and various inflammatory factors all decreased,and the observation group was lower than the control group,with statistically significant differences(P<0.05).The total clinical effective rate of the observation group patients was 95.35%,which was higher than the control group's 81.40%,and the difference was statistically significant(P<0.05).Conclusion The non-invasive ventilator combined with pulmonary rehabilitation program has a significant improvement effect on lung function and quality of life in patients with moderate to severe COPD,and can reduce the level of inflammatory factors and improve the patient's exercise endurance.
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