无创机械通气在老年中重度慢性阻塞性肺疾病患者康复治疗中的作用

目的探讨无创机械通气在呼吸康复训练中对老年中、重度慢性阻塞性肺疾病（COPD）患者的康复效果。方法将80例老年中重度COPD住院患者按照随机数字表法分成康复组和对照组各40例。康复组除采用常规临床治疗、健康教育、运动训练外，均给予无创机械通气治疗。对照组采用多学科综合康复治疗。治疗前、后2组患者均采用体质指数（BMD、气流阻塞程度（Obstrucdon）、呼吸困难指数（Dyspnea）、运动耐力指标（Exercise）即BODE评分评定患者康复情况。同时采用生存质量评分（QOL）评定患者的康复效果。结果治疗1个月后，康复组的BODE评分明显降低。QOL评分也有明显改善，与治疗前比较，差异均有统计学意义（P〈0．05）。结论采用无创机械通气对老年中、重度COPD患者进行呼吸康复训练，能显著降低患者的BODE评分，改善COPD患者的呼吸困难症状，提高运动耐力及改善患者的QOL水平。

Noninvasive positive pressure ventilation (NPPV) therapy for elderly patients with moderate and severe COPD

Objective To study the effect of oninvasive positive pressure ventilation(NPPV) for elderly patients with moderate and severe COPD. Methods Eighty elderly inpatients with moderate and severe COPD were divided into respiratory rehabilitation with noninvasive positive pressure ventilation (NPPV) group (40 cases) and routine control group (40 cases). The rehabilitation group had noninvasive positive pressure ventilation (NPPV) besides routine clinical treatment, health education and exercise training. Control group received only multidiecipli-nary rehabilitation. Patients' rehabilitation status before and after treatment were evaluated with BODE score and rehabilitation effects were evaluated with Quality of Life (QOL) scale. Results BODE and QOL scores had no statistically significant difference in the two groups before treatment (P >0.05). One month after treatment, BODE score of rehabilitation group was obviously lower, QOL scores also were distinctly better than those before treatment. Conclusion Noninvasive positive pressure ventilation (NPPV) can significantly decrease BODE score, improve dyspnea of COPD patients and increase quality of life and exercise tolerance.