早期肺康复联合无创通气对AECOPD患者的治疗效果研究

目的 探究早期肺康复联合无创通气治疗对慢性阻塞性肺疾病急性加重（AECOPD）患者肺功能、生活质量及再入院情况的影响。方法 收集大连市友谊医院2017年11月至2019年5月住院的AECOPD患者92例，随机分为对照组及观察组，对照组患者进行无创通气治疗，观察组患者无创通气治疗同时，早期开展肺康复锻炼，比较两组患者肺功能（FEV1、FVC、FEV1/FVC）、6 min步行试验、血管内皮生长因子、生活质量评分及1年内再入院次数。结果 患者肺功能相关指标中，观察组治疗后FEV1较治疗前明显改善，且差异具有统计学意义（P<0.05）；而FVC及FEV1/FVC，两组患者治疗前后均无明显差异（P>0.05）。治疗后观察组患者FEV1及FEV1/FVC较对照组患者有明显改善（P<0.05）。观察组患者治疗后6 min步行试验结果较治疗前均有显著改善，且差异具有统计学意义（P<0.05）。两组患者治疗后血管内皮生长因子、生活质量评分较治疗前均有所降低，且差异具有统计学意义（P<0.05），其中观察组降低降低程度更大；观察组患者1年内再入院次数少于对照组，且差异具有统计学意义（P<0.05）。结论 早期肺康复联合无创通气治疗可以提高AECOPD患者活动耐力，改善其生活质量，减少再入院次数。

Effect of early pulmonary rehabilitation combined with noninvasive ventilation on AECOPD patients

Objective To investigate the effects of early pulmonary rehabilitation combined with non-invasive ventilation on pulmonary function, quality of life and readmission in AECOPD patients. Methods Totally 92 patients were randomly divided into control group treated with noninvasive ventilation and observation group with noninvasive ventilation and pulmonary rehabilitation. The pulmonary functions (including FEV1, FVC, FEV1/FVC), 6-min walking test, vascular endothelial growth factor (VEGF), mMRC and readmission within one year were collected before and after treatment. Results Among the pulmonary function indicators, FEV1 was significantly improved in the observation group after treatment compared to that before treatment (P<0.05). However, no significant differences were noted on FVC and FEV1/FVC in both groups before and after treatment. After treatment, FEV1 and FEV1/FVC of the observation group inereased significantly than the control group(P<0.05)The 6 min walking tests were significantly higher in the observation groups than those before treatment. VEGF and mMRC scores were decreased in both groups after treatment, especially in the observation group (P<0.05). The number of readmission within 1 year in the observation group was less than that in the control group (P<0.05). Conclusion Early pulmonary rehabilitation combined with noninvasive ventilation can advance activity endurance, improve quality of life and reduce the number of readmission in patients with AECOPD.