体外隔肌起搏仪联合阻力呼吸训练在慢性阻塞性肺疾病伴呼吸衰竭患者的应用分析

doi:10.3969/j.issn.1006-6233.2025.02.025

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摘要 目的: 探究体外隔肌起搏仪(EDP)联合阻力呼吸训练对稳定期慢性阻塞性肺疾病(COPD)伴呼吸衰竭患者肺功能和生活质量的影响。方法: 前瞻性选取本院2021年3月至2024年3月收治的稳定期COPD伴呼吸衰竭患者120例,行随机数表法分为试验组和对照组,各60例。对照组给予常规干预联合缩唇腹式呼吸训练,试验组在常规干预基础上加用体外隔肌起搏仪联合阻力呼吸训练,干预8周。观察两组干预前后肺功能[用力肺活量(FVC)、第1秒呼气容积(FEV1)及第1秒用力呼气容积占用力肺活量百分比值(FEV1/FVC%)]、呼吸肌生理学[最大呼气压(MEP)与最大吸气压(MIP)]、呼吸困难程度评分(MMRC)、6min步行试验距离(6MWT)、生活质量(COPD评估测试,CAT)及患者满意率。结果: 干预后,两组FVC、FEV1、FEV1/FVC%、MEP及MIP水平、6MWT距离均较干预前升高,且试验组各项水平均高于对照组(P<0.05);试验组FVC、FEV1、FEV1/FVC%、MEP及MIP水平、6MWT距离干预前后差值分别为(-0.69±0.19)L、(-0.49±0.17)L、(-10.62±2.57)、(-0.82±0.23)Pa、(-0.48±0.15)Pa、(-138.76±16.84)m,变化幅度均大于对照组的(-0.15±0.08)L、(-0.21±0.12)L、(-4.12±1.45)、(-0.51±0.17)Pa、(-0.38±0.11)Pa、(-115.86±14.37)m(P<0.05);干预后,两组MMRC评分及CAT评分均较干预前降低,且试验组各项水平均低于对照组(P<0.05);MMRC评分及CAT评分干预前后差值分别为(1.39±0.28)分、(14.01±2.64)分,变化幅度均大于对照组的(0.60±0.17)分、(11.34±1.86)分(P<0.05);干预后,实验组患者满意率为95.00%,高于对照组的81.67%(P<0.05)。结论: EDP联合阻力呼吸训练能加强COPD伴呼吸衰竭患者肺功能,缓解呼吸衰竭症状,提升运动耐力,改善生活质量,提升患者满意率。

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	王侠龄
	杨扬
	张琰

关键词 ：慢性阻塞性肺疾病, 呼吸衰竭, 体外隔肌起搏仪, 阻力呼吸训练

Abstract：Objective: To investigate the effects of external diaphragm pacemaker (EDP) combined with resistance breathing training on lung function and quality of life in patients with stable chronic obstructive pulmonary disease and respiratory failure. Methods: According to a random number table, 120 patients with stable COPD and respiratory failure admitted to in the hospital were prospectively enrolled into control group (routine intervention combined with pursed-lip abdominal breathing training, n=60) and experimental group (EDP combined with resistance breathing training based on routine nursing, n=60) between March 2021 and March 2024. All patients were intervened for 8 weeks. Before and after intervention, lung function including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and ratio of FEV1 to FVC (FEV1/FVC%), physiology of respiratory muscles including maximum expiratory pressure (MEP) and maximum inspiratory pressure (MIP), modified British Medical Research Council (mMRC) dyspnea scale, 6-min walking test (6MWT) and quality of life, COPD assessment test (CAT), as well as the satisfaction rates of patients in the two groups were observed. Results: After intervention, FVC, FEV1, FEV1/FVC%, MEP, MIP and 6MWT distance were significantly increased in both groups, and which were significantly higher in experimental group than control group (P<0.05). After intervention, difference values of FVC (-0.69±0.19L vs -0.15±0.08L), FEV1 (-0.49±0.17L vs -0.21±0.12L), FEV1/FVC% (-10.62±2.57 vs -4.12±1.45), MEP (-0.82±0.23 Pa vs -0.51±0.17Pa ), MIP (-0.48±0.15 Pa vs -0.38±0.11 Pa) and 6MWT distance (-138.76±16.84 m vs -115.86±14.37 m) in experimental group were greater than those in control group (P＜0.05). After intervention, scores of mMRC and CAT were significantly decreased in both groups, and which were significantly lower in experimental group than control group (P<0.05). Before and after intervention, difference values of mMRC (1.39±0.28 points vs 0.60±0.17 points) and CAT (14.01±2.64 points vs 11.34±1.86 points) scores in experimental group were greater than those in control group (P<0.05). After intervention, the satisfaction rate in experimental group was significantly higher than that in control group (95.00% vs 81.67%, P<0.05). Conclusion: EDP combined with resistance breathing training can enhance lung function, relieve respiratory failure symptoms, improve exercise tolerance, quality of life and satisfaction rate in patients with COPD and respiratory failure.

Key words： Chronic obstructive pulmonary disease Respiratory failure External diaphragm pacemaker Resistance breathing training

基金资助:内蒙古自治区自然科学基金项目,(编号:2020MS08049)

通讯作者: 张琰

引用本文:

王侠龄, 杨扬, 张琰. 体外隔肌起搏仪联合阻力呼吸训练在慢性阻塞性肺疾病伴呼吸衰竭患者的应用分析[J]. 河北医学, 2025, 31(2): 315-320.
WANG Xialing, YANG Yang, ZHANG Yan. Application of External Diaphragm Pacemaker Combined with Resistance Breathing Training in Patients with Chronic Obstructive Pulmonary Disease and Respiratory Failure. HeBei Med, 2025, 31(2): 315-320.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.02.025 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I2/315

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