【摘要】 目的 :评价双水平持续气道正压通气(Bi PAP)在慢性阻塞性肺疾病(COPD)患者康复运动中的疗效。方法:共58例COPD患者入选本研究,其中24例患者进入肺康复联合呼吸机治疗组,34例患者进入肺康复治疗组,均完成8周的治疗。2组患者在治疗前、后均进行BODE指数、主观用力程度(RPE)计分、日常生活活动能力评定及动脉血气分析,并对相关结果进行对比分析。结果:经肺康复联合呼吸机治疗8周后,该组在6 min步行距离(6MWD)、BODE指数评分较肺康复治疗组明显改善(P=0.047,P=0.045)。治疗后第1秒用力呼气容积占预计值百分比[FEV1/预计值(%)]、改良的英国医学研究会呼吸困难量表(MMRC)评分、体质量指数(BMI)2组无明显差异(均P>0.05)。治疗后RPE评分、Barthel指数(BI)肺康复联合呼吸机治疗组较肺康复治疗组明显改善(P<0.01)。治疗后动脉血气分析p H、氧分压(Pa O2)肺康复联合呼吸机治疗组较肺康复治疗组明显改善(P=0.002,P=0.041);二氧化碳分压(Pa CO2)2组无明显差异(P>0.05)。结论:在肺康复运动中,应用Bi PAP能明显改善COPD患者的运动耐力及生活质量。更多还原

【Abstract】 Objective To evaluate the therapeutic efficacy of bi-level positive airway pressure ventilation(Bi PAP) in pulmonary rehabilitation for patients with chronic obstructive pulmonary disease(COPD). Methods Fifty-eight patients with COPD were divided into two groups: 24 patients in treatment group were given Bi PAP in addition to conventional pulmonary rehabilitation for 8 weeks, while 34 patients were dedicated to conventional pulmonary rehabilitation group.BODE index, rate of perceived exertion(RPE), arterial blood gas analysis, Barthel index(BI) were assessed and compared pre- and post-8-week of the therapeutic program. Results After 8 weeks of treatment, the BODE index(P=0.045), 6 minute walk distance(6MWD)(P =0.047), RPE and BI(P <0.01) in Bi PAP in addition to conventional pulmonary rehabilitation group were significantly improved when compared with the conventional pulmonary rehabilitation group. There were no differences between the two groups in forced expiratory volume in one second( FEV1)(% predicted), modified Medical Research Council(MMRC) scale and body mass index(BMI). The results of arterial blood gas analysis in Bi PAP in addition to conventional pulmonary rehabilitation group were improved significantly(P<0.05) when compared with the conventional pulmonary rehabilitation group, such as potential of hydrogen(P=0.002) and arterial partial pressure of oxygen(P=0.041),while there was no difference between the two groups in arterial partial pressure of carbon dioxide. Conclusions The addition of Bi PAP could improve significantly the endurance to exercise and quality of life in COPD patient.更多还原