陈瑞英,马小花,孙婷,等.短期强化肺康复训练对OSA-COPD共存患者呼吸、运动功能及生活质量的影响[J].中华物理医学与康复杂志,2019,41(5):353-358
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| 短期强化肺康复训练对OSA-COPD共存患者呼吸、运动功能及生活质量的影响 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2019.05.009 |
| 中文关键词: 强化肺康复训练 阻塞性睡眠呼吸暂停 慢性阻塞性肺疾病 肺功能 运动能力 生活质量 |
| 英文关键词: Pulmonary rehabilitation Sleep Apnea Obstructive pulmonary disease Lung function Motor function Quality of life |
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| 中文摘要: |
| 目的 观察短期强化肺康复训练对阻塞性睡眠呼吸暂停（OSA)-慢性阻塞性肺疾病（COPD）共存患者呼吸、运动功能及生活质量的影响。 方法 采用随机数字表法将57例OSA-COPD共存患者分为观察组及对照组，2组患者均予以夜间无创气道正压通气（NPPV）、氧疗及支气管舒张剂治疗，观察组同时辅以8周强化肺康复训练（包括呼吸功能训练及肢体运动训练等）。于入选时、治疗8周后对2组患者进行多导睡眠监测［监测指标包括呼吸暂停低通气指数（AHI）、夜间最低血氧饱和度（LowSpO2）、夜间血氧饱和度<90%时间占总睡眠时间比值（TST90）等］、动脉氧分压（PaO2）分析、肺功能测定［检测指标包括用力肺活量（FVC）、1秒用力呼气容积（FEV1）及FEV1/FVC%等］、6分钟步行试验（6MWT）及圣乔治呼吸问卷（SGRQ）评分等。 结果 治疗8周后2组患者AHI、LowSpO2、TST90及PaO2均较治疗前明显改善(P<0.05)，且上述指标组间差异均无统计学意义（P>0.05）。治疗8周后观察组FVC、FEV1及6MWT［分别是 (2.23±0.38)L、(1.41±0.28)L及(397.3±71.3)m］均显著优于治疗前及对照组水平（P<0.05）；治疗后观察组SGRQ症状、活动能力、疾病影响日常生活评分及总分［分别是 (52.26±8.78) 分、（71.34±10.65）分、（42.53±10.23）分及（51.31±13.35）分］均显著优于治疗前及对照组水平（P<0.05)。 结论 NPPV可有效提高OSA-COPD共存患者对短期强化肺康复训练的耐受性；在此基础上辅以短期强化肺康复训练（以呼吸功能训练及肢体运动训练为主）能进一步促进患者呼吸功能、运动功能恢复，提高患者生活质量，该联合疗法值得临床推广、应用。 |
| 英文摘要: |
| Objective To explore the effect of short-term intensive rehabilitation training on respiratory function, motor function and the life quality of patients with obstructive sleep apnea combined with chronic obstructive pulmonary disease (OSA-COPD). Methods Fifty-seven patients with OSA-COPD were randomly divided into an observation group and a control group. Both groups were treated with non-invasive positive pressure ventilation (NPPV), oxygen therapy and a bronchodilator, while the observation group was additionally provided with 8 weeks of intensive lung rehabilitation training, including respiratory function training and limb exercise training. Polysomnography was used to monitor the apnea hyponea index (AHI), the lowest oxygen saturation level during the night (LowSpO2) and the nocturnal oxygen saturation ratio for < 90% of total sleep time (tst90). Arterial blood gases, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were measured. The 6-minute walk test (6MWT) and St. George′s respiratory questionnaire (SGRQ) were used to evaluate all the patients before and after the intervention. Results After 8 weeks of treatment, the average AHI, LowSpO2, TST90 and PaO2 had improved significantly in both groups. There was no significant difference between them. After the treatment the average FVC, FEV1 and 6MWT time of the observation group were significantly better than before the treatment and the significantly better than the control group′s averages. After treatment, the average SGRQ score and activity ability score of the observation group were also significantly improved and significantly better than the control group′s averages. Conclusions NPPV can effectively improve OSA-COPD patients′ tolerance of short-term intensive pulmonary rehabilitation training. With that assistance, short-term intensive rehabilitation training can promote the recovery of respiratory function and motor function, and improve the life quality of patients. Therefore, such therapy is worthy of clinical promotion and application. |
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