无创正压通气结合呼吸功能锻炼对稳定期慢性阻塞性肺疾病患者肺康复效果分析

目的 对比单纯无创正压通气（NIPPV）治疗，与NIPPV结合呼吸功能锻炼对稳定期慢性阻塞性肺疾病（简称慢阻肺）患者肺康复的效果。方法 抽取2017年6月至2019年6月期间常熟市第二人民医院呼吸内科收治的稳定期慢阻肺患者80例作为研究对象，随机分为对照组与研究组,各40例。在常规治疗基础上对照组行NIPPV治疗，研究组在上述基础上结合呼吸功能锻炼，分别于治疗前、治疗2周后评估两组患者肺功能、动脉血气、呼吸肌功能以及运动耐力、呼吸困难程度。结果 干预后对照组肺功能及呼吸肌功能指标较干预前无明显变化（P>0.05），动脉血氧分压（PaO2）、6 min步行距离（6MWD）明显升高，动脉血二氧化碳分压（PaCO2）及Borg评分明显降低（P<0.05）；研究组患者肺功能指标、PaO2、（MIP）、最大呼气压（MEP）及6MWD明显升高，PaCO2及Borg评分明显降低，且研究组改善情况明显优于对照组（P<0.05）。结论 NIPPV结合呼吸功能锻炼可有效改善慢阻肺患者肺功能及呼吸肌功能，减轻其缺氧及呼吸困难程度，增加其运动耐力，在慢阻肺治疗中具有重要意义。

Pulmonary rehabilitation effect of noninvasive positive pressure ventilation combined with respiratory function exercise on patients with stable chronic obstructive pulmonary disease

Objective To explore the effect of noninvasive positive pressure ventilation (NIPPV) combined with breathing exercises on the pulmonary rehabilitation of patients with stable chronic obstructive pulmonary disease (COPD). Methods From June 2017 to June 2019, 80 patients with stable COPD admitted to the Department of Respiratory Medicine of Changshu Second People''s Hospital were selected and randomly divided into control group and study group. On the basis of conventional treatment, the patients in control group received NIPPV treatment. And the patients in study group were treated with the NIPPV treatment combined with respiratory function exercise in addition. The lung function, arterial blood gas, respiratory muscle function, exercise endurance, and dyspnea degree of the two groups before and after 2 weeks of treatment were compared between the two groups. Results After the intervention, there was no significant difference on pulmonary function and respiratory muscle function indexes in control group (P>0.05). In control group, arterial oxygen partial pressure(PaO2) and 6 min walking distance (6MWD) increased significantly, and arterial partial pressure of carbon dioxide (PaCO2) and Borg scores reduced significantly (P<0.05). The lung function indicators, PaO2, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and 6MWD were significantly increased in study group. PaCO2 and Borg scores significantly reduced as well. The improvement rate of the study group was significantly higher than that of the control group (P<0.05). Conclusions NIPPV combined with respiratory function exercise can effectively improve the lung function and respiratory muscle function of patients with COPD, reduce the incidence of hypoxia and dyspnea, and increase exercise endurance. It is of great significance in the treatment of COPD.