呼吸训练器辅助下呼吸康复对新型冠状病毒肺炎患者的疗效

目的 观察呼吸康复在新型冠状病毒肺炎(COVID-19)患者中的疗效,以及不同呼吸训练方法 对疗效的影响.方法 选择2020年2月4日至3月25日武汉市金银潭医院某病区集中收治的病情稳定、有主动康复意愿的普通型或重型COVID-19患者21例,随机分为3组,每组7例.除了针对COVID-19的常规药物及对症支持治疗外,...

Respiratory rehabilitation assisted by respiratory trainers in patients with coronavirus disease 2019: an analysis of efficacy

Objective To observe the effect of respiratory rehabilitation on coronary virus disease 2019 (COVID-19) patients. Methods Twenty-one patients of common or severe COVID-19 with positive rehabilitation willingness were enrolled from Feb. 4 to Mar. 25, 2020, in Wuhan Jinyintan Hospital. They were randomly divided into three groups. Each group included with 7 patients. In addition to the conventional drugs and supportive treatments, the three groups of patients were given respiratory training using Shun-qing deep breathing training device (group A), Acapella respiration training device (group B) and Leventon Spiro-Ball respiration training device (group C), respectively. Patients were instructed on respiratory function and sputum production training for 7 consecutive days, twice per day and 30 minutes every time. Four patients without rehabilitation willingness were enrolled as the control group, and given COVID-19 routine drugs together with symptomatic support therapy. Dyspnea voluntary exertion rating (modified RPE scale), total sputum rating, respiratory frequency measurement, pulse oxygen saturation (SpO2) measurement and activities of daily living (ADL) rating (modified Barthel index) were assessed before and 7 days after rehabilitation training. Results No significant differences among 4 groups were observed with regard to age, gender, RPE score, SpO2 value with no oxygen to support, sputum volume proportion and ADL score among 4 groups before training. However, the difference of breathing frequency among four groups was statistically significant. RPE score, breathing frequency and SpO2 value with no oxygen to support and ADL score in Group A, B and C improved obviously after 7 days of training. The differences of these 4 indicators before and after training within group were all statistically significant (P<0.05). The differences among 4 groups in these 4 indicators after training were all statistically significant (P<0.01). Pairwise comparison showed that differences of above 4 indicators for Group A and controls, and for Group B and controls reached the statistical significance(P<0.05), however, only difference of breathing frequency between Group C and controls were statistically significant after training. Besides, the difference of pairwise comparison among Group A, B and C with regard to these 4 indicators did not see the statistical significance. The sputum volume of the four groups post-training all decreased compared with that pre-training. The differences of proportion of sputum volume before and after training in Group A, B and C were statistically significant except for control group. And the overall difference of proportion of sputum volume among 4 groups was not statistically significant. Conclusion Respiratory rehabilitation assisted by respiratory trainer effectively improves the respiratory symptoms of ordinary and severe type COVID-19, reduces sputum secretion, improves respiratory function, and the activities of daily living. Due to the small number of samples in this experiment, the specific mechanism of action and the effect of different breathing trainers requires future multi-center studies.