不同自主呼吸训练方法对区域性肺通气影响的对比研究
A comparative study on the impact of different autonomous breathing exercises on regional pulmonary ventilation
高志君 1赵珂 2代萌 3王春晨 1刘洋 1秦义隆 1代静 1王航 1文治洪 1曹新生 1杨琳1
作者信息
- 1. 第四军医大学航空航天医学系航空航天人机工效学教研室,陕西省西安市,710032
- 2. 空军第九八六医院呼吸内科
- 3. 第四军医大学军事生物医学工程学系医学电子工程教研室
- 折叠
摘要
目的:利用生物电阻抗成像(EIT)技术探究不同自主呼吸训练方法对区域性肺通气的影响,以期为慢性阻塞性肺疾病(COPD)患者在训练标准及方法选取上提供行之有效的康复指导方案.方法:共纳入28名健康志愿者,取舒适站立位并进行:①平静呼吸;②腹式呼吸;③缩唇呼吸;④腹式缩唇呼吸,每位被试的四种呼吸方式随机决定,整个过程中连续记录胸部EIT;分别对比四种呼吸方式期间的潮气量(TV)、呼气末肺阻抗(EELI)、通气中心(center of ventilation,CoV)、不均一指数(GI)、区域通气延迟(RVD).结果:较平静呼吸,腹式呼吸、缩唇呼吸及腹式缩唇呼吸三种呼吸训练方法期间的TV明显增大(P＜0.05);EELI明显降低(P＜0.05);CoV明显减小(P＜0.05,腹侧通气增多);腹式呼吸和腹式缩唇呼吸的GI明显减小(P＜0.05,通气更均匀);缩唇呼吸和腹式缩唇呼吸RVD明显增加(P＜0.05).结论:腹式呼吸、缩唇呼吸、腹式缩唇呼三种呼吸训练方法均能有效增加肺通气量,减少肺功能残气量,但三种呼吸训练方法对肺通气的影响各不相同:缩唇呼吸通气向腹侧移动更显著(COV更小),区域通气延迟更显著(RVD更大),而腹式呼吸可改善通气均匀性(GI更小).因此,从区域性肺通气的角度,建议COPD患者在进行呼吸训练时应腹式呼吸与缩唇呼吸独立交替进行,以达到更好的呼吸训练效果.
Abstract
Objective:To explore the impact of different autonomous breathing exercises on regional pulmonary ventila-tion using electrical impedance tomography(EIT),in order to provide effective rehabilitation guidance for pa-tients with chronic obstructive pulmonary disease(COPD)in selecting exercise standards and methods.Method:A total of 28 healthy volunteers were recruited in the study,who performed the following breathing exercises in a comfortable standing position:①quiet breathing;②diaphragmatic breathing;③pursed-lip breath-ing;④pursed-lip combining diaphragmatic breathing.The four breathing modes were randomly determined for each subject.Chest EIT was continuously performed during the whole process.The tidal volume(TV),end-ex-piratory lung impedance(EELI),center of ventilation(CoV),global inhomogeneity index(GI)and regional ventilation delay(RVD)were compared during the four breathing modes.Result:Compared with quiet breathing,diaphragmatic breathing,pursed-lip breathing,and diaphragmatic pursed-lip breathing significantly increased TV(P＜0.05),reduced EELI(P＜0.05)and decreased CoV(P＜0.05,with in-creased ventral ventilation).GI of diaphragmatic breathing and pursed lip combining diaphragmatic breathing was significantly reduced(P＜0.05,more uniform ventilation),while RVD of pursed lip breathing and pursed lip combining diaphragmatic breathing was significantly increased(P＜0.05).Conclusion:Diaphragmatic breathing,pursed-lip breathing,and pursed-lip combining diaphragmatic breathing can effectively increase pulmonary ventilation and reduce pulmonary functional residual volume.However,the three breathing exercises have different impacts on pulmonary ventilation:pursed-lip breathing shifts ventilation more significantly towards the ventral side(smaller COV),and has a more significant regional ventilation de-layed(larger RVD),while diaphragmatic breathing improves ventilation homogeneity(smaller GI).Therefore,from the perspective of regional pulmonary ventilation,it is recommended that COPD patients should alternate between diaphragmatic breathing and pursed-lip breathing independently during breathing exercises to achieve better breathing exercise effects.
关键词
生物电阻抗成像技术/区域性肺通气/腹式呼吸/缩唇呼吸/慢性阻塞性肺疾病Key words
electrical impedance tomography/regional pulmonary ventilation/diaphragmatic breathing/pursed lip breathing/chronic obstructive pulmonary disease引用本文复制引用
出版年
2024
NETL
NSTL
万方数据