体外膈肌起搏对慢性呼吸衰竭患者肺功能和运动耐力的影响

Yanyan Ding, Yongxiang Zhang, Ruimin Li, Lei Xue
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The levels of partical pressure of oxygen in artery and arterial oxygen saturation in the observation group after treatment were significantly higher than those before treatment and after treatment in the control group (all P<0.05). Partical pressure of carbon dioxide in artery in the observation group was significantly lower than that before treatment and after treatment in the control group (all P<0.05). After treatment, the levels of myoglobin, creatine kinase and lactate dehydrogenase in the observation group were significantly lower than those before treatment and after treatment in the control group (all P<0.05). After treatment, the scores of cough, sputum, chest tightness, climbing, housework, confidence in outdoor activities, sleep and spirit in the observation group were significantly lower than those before treatment and after treatment in the control group (all P<0.05). 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引用次数: 0

摘要

目的探讨外膈起搏对慢性呼吸衰竭患者肺功能和运动耐力的影响。方法选取2017年5月~ 2018年5月首都医科大学大兴附属医院收治的慢性阻塞性肺疾病患者120例作为研究对象,采用随机数字表法分为观察组和对照组,每组60例。对照组患者给予常规治疗,观察组患者在对照组基础上行体外膈肌起搏。比较两组患者治疗前后第一秒用力呼气量、第一秒用力呼气量/用力肺活量、用力肺活量、动脉氧分压、动脉氧饱和度、动脉二氧化碳分压、肌红蛋白、肌酸激酶、乳酸脱氢酶等指标。比较两组患者治疗前后慢性阻塞性肺疾病评估测试和改良英国医学研究委员会(mMRC)评分。结果治疗后,观察组患者第一秒用力呼气量、第一秒用力呼气量/用力肺活量、每分钟最大通气量均显著高于对照组治疗前和治疗后(P<0.05)。观察组治疗后动脉血氧分压、动脉血氧饱和度均显著高于对照组治疗前和治疗后,差异均有统计学意义(P<0.05)。观察组患者动脉二氧化碳分压显著低于对照组治疗前和治疗后,差异均有统计学意义(P<0.05)。治疗后观察组患者肌红蛋白、肌酸激酶、乳酸脱氢酶水平均显著低于对照组治疗前和治疗后,差异均有统计学意义(P<0.05)。治疗后观察组患者咳嗽、痰液、胸闷、攀爬、家务劳动、户外活动信心、睡眠、精神等得分均显著低于对照组治疗前和治疗后,差异均有统计学意义(P<0.05)。两组患者治疗前mMRC分级比较,差异无统计学意义(Z=0.283, P=0.963)。治疗后,观察组患者mMRC评分显著低于对照组(Z=9.318, P=0.025)。结论体外膈肌起搏治疗慢性阻塞性肺疾病可改善患者肺功能,缓解患者临床症状,提高运动耐力,值得临床推广应用。关键词:肺部疾病;慢性阻塞性肺疾病;呼吸功能检查;外膈起搏;运动耐力
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Effects of extracorporeal diaphragmatic pacing on pulmonary function and exercise endurance in patients with chronic respiratory failure
Objective To study the effect of external diaphragmatic pacing on lung function and exercise endurance in patients with chronic respiratory failure. Methods There were 120 patients with chronic obstructive pulmonary disease admitted to Daxing Teaching Hospital, Capital Medical University from May 2017 to May 2018 selected as study subjects, and divided into observation group and control group by random number table method, with 60 cases in each group.Patients in the control group were given conventional treatment, and patients in the observation group were treated with extracorporeal diaphragmatic pacing on the basis of the control group.The indexes of forced expiratory volume in the first second, forced expiratory volume in the first second/forced vital capacity, forcad vital capacity, partical pressure of oxygen in artery, arterial oxygen saturation, partical pressure of carbon dioxide in artery, myoglobin, creatine kinase and lactate dehydrogenase before and after treatment in the two groups were compared.Chronic obstructive pulmonary disease assessment test and modified British medical research council (mMRC) scores before and after treatment were compared between the two groups. Results After treatment, the levels of forced expiratory volume in the first second, forced expiratory volume in the first second/forced vital capacity and maximum ventilation per minute in the observation group were significantly higher than those before treatment and after treatment in the control group (all P<0.05). The levels of partical pressure of oxygen in artery and arterial oxygen saturation in the observation group after treatment were significantly higher than those before treatment and after treatment in the control group (all P<0.05). Partical pressure of carbon dioxide in artery in the observation group was significantly lower than that before treatment and after treatment in the control group (all P<0.05). After treatment, the levels of myoglobin, creatine kinase and lactate dehydrogenase in the observation group were significantly lower than those before treatment and after treatment in the control group (all P<0.05). After treatment, the scores of cough, sputum, chest tightness, climbing, housework, confidence in outdoor activities, sleep and spirit in the observation group were significantly lower than those before treatment and after treatment in the control group (all P<0.05). There was no significant difference in mMRC grade between the two groups before treatment (Z=0.283, P=0.963). After treatment, the mMRC grade of the observation group was significantly lower than that of the control group (Z=9.318, P=0.025). Conclusions Extracorporeal diaphragmatic pacing for the treatment of chronic obstructive pulmonary disease can improve the patient′s lung function, relieve the patient′s clinical symptoms, improve exercise endurance, worthy of clinical application. Key words: Pulmonary disease, chronic obstructive; Respiratory function tests; External diaphragmatic pacing; Exercise endurance
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