[1]章陈晨,刘凌琳,宋双双,等.不同物理疗法对重度慢性阻塞性肺疾病急性加重期患者肺康复效果的影响[J].第三军医大学学报,2019,41(18):1782-1788.
 ZHANG Chenchen,LIU Linglin,SONG Shuangshuang,et al.Efficacy of different physiotherapies for pulmonary rehabilitation in patients with acute exacerbation of severe chronic obstructive pulmonary disease[J].J Third Mil Med Univ,2019,41(18):1782-1788.
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不同物理疗法对重度慢性阻塞性肺疾病急性加重期患者肺康复效果的影响(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第18期
页码:
1782-1788
栏目:
临床医学
出版日期:
2019-09-30

文章信息/Info

Title:
Efficacy of different physiotherapies for pulmonary rehabilitation in patients with acute exacerbation of severe chronic obstructive pulmonary disease
作者:
章陈晨刘凌琳宋双双熊玮
陆军军医大学(第三军医大学)第一附属医院老年医学和特勤医学科
Author(s):

Department of Geriatrics and Special Medical Services, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
物理疗法HFCWO治疗ELTGOL治疗慢性阻塞性肺部疾病急性加重期肺康复
Keywords:
physiotherapy high-frequency chest wall oscillation expiration with the glottis open in the lateral posture acute exacerbation of chronic obstructive pulmonary disease pulmonary rehabilitation
分类号:
R181.32; R454; R563.805
文献标志码:
A
摘要:

目的 观察不同物理疗法对重度慢性阻塞性肺部疾病急性加重期(acute exacerbation of chronic obstructive pulmonary diseases,AECOPD)患者肺康复的效果。方法 纳入2016年1月至2018年9月本院内科收治的68例重度AECOPD患者,均进行常规药物治疗,通过随机分配分为对照组(n=20,仅采用常规治疗,不接受任何呼吸以及排痰辅助治疗)、高频胸壁振荡排痰系统(high-frequency chest wall oscillation system expectoration,HFCWO)治疗组(n=24,在常规治疗基础上接受HFCWO治疗)和开放声门侧体位呼气(expiration with the glottis open in the lateral posture, ELTGOL)治疗组(n=24,在常规治疗基础上接受ELTGOL治疗)。患者均干预2周,观察和评估3组患者干预前后的肺功能指标、血气相关指标、临床症状评分、住院时间、生活质量评分的变化。结果 治疗后,HFCWO组和ELTGOL组患者的PEF、FVC、FEV1、FEV1/FVC均高于对照组(P<0.05);HFCWO组和ELTGOL组患者的PaO2高于对照组,PaCO2小于对照组(P<0.05);HFCWO组和ELTGOL组患者的咳嗽评分、咳痰评分、喘息评分、哮鸣评分、气短评分等临床症状评分明显低于对照组(P<0.05);HFCWO组和ELTGOL组患者的咳痰好转时间和住院时间短于对照组(P<0.05);HFCWO组和ELTGOL组患者的生活治疗中的症状评分、活动评分、影响评分和总评分均低于对照组(P<0.05),HFCWO组患者的症状评分、活动评分、影响评分和总评分均低于ELTGOL组(P<0.05)。3组患者对治疗的耐受性比较差异无统计学意义(P>0.05)。结论 HFCWO和ELTGOL均能有效改善对重度AECOPD患者的肺功能和血气水平,但HFCWO治疗效果更佳。

Abstract:

Objective To assess the effect of different physical therapies for pulmonary rehabilitation in patients with acute exacerbation of severe chronic obstructive pulmonary diseases (AECOPD). MethodsBetween January, 2016 and September, 2018, a total of 68 inpatients with AECOPD were randomized for treatment with high-frequency chest wall oscillation (HFCWO group, n=24), expiration with the glottis open in the lateral posture (ELTGOL group, n=24), or routine treatment without assisted ventilation or expectoration (control group, n=20). All the patients were given routine medications in addition to the specified treatments for 2 weeks, and the changes in the pulmonary function indexes, blood gas parameters, clinical symptom scores, hospital stay and the quality of life scores were assessed after the treatments. ResultsCompared with those in the control group, the patients in both the HFCWO group and ELTGOL group showed significant improvements in pulmonary function indexes and blood gas parameters (P<0.05) with significantly reduced clinical symptom scores (P<0.05) after the treatments. The quality of life score was also significantly improved after the treatments in HFCWO and ELTGOL groups (P<0.05), which had significantly shorter hospital stay compared than the control group (P<0.05). These improvements were significantly more obvious in HFCWO group than in ELTGOL group. ConclusionBoth HFCWO and ELTGOL can effectively improve the pulmonary function and blood gas parameters in patients with severe AECOPD, but HFCWO can produce better therapeutic effect than ELTGOL.

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更新日期/Last Update: 2019-09-21