主动呼吸循环技术对急性加重期COPD患者能量消耗和排痰效果的干预研究

目的：评价主动呼吸循环技术对急性加重期 COPD（AECOPD）患者的干预效果。方法将70例AECOPD患者分别纳入多痰组（日排痰量≥30 g ）和少痰组（日排痰量＜30 g ），各35例。所有患者采用自身配对设计，在常规治疗的基础上采用主动呼吸循环技术（ACBT ）干预和呼吸科常规护理干预，采用密闭信封方法确定两种方法的随机干预顺序，比较患者排痰量、SpO2及咳嗽次数的改变情况。结果多痰组：ACBT较常规护理干预未能提高AECOPD患者1 d的排痰总量；能提高干预期间和干预后1 h排痰量，咳嗽频率显著增高，SpO2升高不明显。少痰组：ACBT较常规干预能提高AECOPD患者1 d的排痰总量；干预期间和干预后1 h排痰量几无变化，未能进行统计分析，咳嗽频率显著增高，SpO2改善明显。多痰组和少痰组患者干预后自我感觉都较好，未出现严重不良反应。结论 ACBT干预处于急性加重期的COPD患者，在咳嗽次数增加致使耗氧量提高的情况下，患者仍能够耐受，且有一定的促进排痰和呼吸锻炼效果，无不良反应发生。

Energy consumption and expectoration effect for patients with acute exacerbation of COPD by active breathing cycle technology intervention

Objective To assess the intervention effect of active breathing cycle technology intervention for patients with acute exacerbation of COPD （AECOPD） .Method 35 patients with AECOPD was randomly divided into phlegmatic group （daily sputum ≥30 g/d） ,and 35 in less sputum group （daily sputum 〈30 g/d） .All patients using their own matching design ,Using active breathing cycle technology （ACBT） intervention and usual care inter-vention on the basis of respiratory conventional therapy ,the enclosed envelope method was used to determine the random order of intervention by the two methods .Changing in patients＇sputum volume ,SpO2 and cough frequency was observed and compared .Result Phlegmatic Group ：ACBT compared with routine care interventions failed to increase the total sputum daily amount or patients with AECOPD .1h sputum volume during and after the intervention was increased .Cough frequency was significantly increased .SpO2 was not obvious elevated .Less sputum Group ：the total sputum daily amount for patients with AECOPD was increased more by ACBT compared with conventional intervention .1h expectoration was not changed during and after the intervention and failed to perform sta-tistical analysis .Cough frequency was significantly increased .SpO2 improved significantly .self feel was better both for phlegmatic group and less sputum group after intervention .No serious adverse events occurred .Conclusion Active cycle of breathing techniques is safe for intervening acute exacerbation for COPD patients and improving in secretion clearance .The patient is still able to tolerate increasing cough frequencies resulting in more energy expendi-ture .No adverse reactions occur .