Acapella呼吸训练器联合体外膈肌起搏在老年慢性阻塞性肺疾病稳定期患者肺康复中的应用

Application of Acapella breathing trainer combined with external diaphragm pacing in pulmonary rehabilitation for elderly patients with stable chronic obstructive pulmonary disease

中文关键词: 肺疾病  慢性阻塞性  Acapella呼吸训练器  体外膈肌起搏  肺康复

英文关键词: pulmonary disease  chronic obstructive  Acapella breathing trainer  external diaphragm pacing  pulmonary rehabilitation

中文摘要:

      目的 分析 Acapella 呼吸训练器联合体外膈肌起搏(EDP)在老年稳定期慢性阻塞性肺疾病(COPD)患者肺康复中的应用效果.方法 选取2024 年1 月至2024 年 12 月医院收治的 102 例老年 COPD 稳定期患者,按照随机数字表法,分为2 组,每组51 例.对照组接受常规肺康复训练,观察组采用 Acapella 呼吸训练器联合 EDP 方案.分别于治疗前和治疗3 个月后比较2 组肺功能、运动耐力、生活质量、COPD 症状及再发风险等指标.结果 治疗前2 组第1 秒用力呼气容积%(FEV1%)、用力肺活量(FVC)、FEV1/FVC、6 min 步行距离(6MWD)、圣乔治呼吸问卷(SGRQ)评分、改良英国医学研究委员会呼吸困难量表(mMRC),以及 COPD 评估测试量表(CAT)得分差异无统计学意义(均 P>0.05);治疗 3个月后,2 组 FEV1%、6MWD 均显著升高(均 P<0.05),SGRQ、mMRC 及 CAT 评分均显著下降(均 P<0.05);且观察组治疗后 FEV1%、FVC、FEV1/FVC 均显著高于对照组[(41.28±8.85)%比(33.27±9.13)%,(1.90±0.52)L 比(1.71±0.49)L,(55.29±7.93)%比(49.28±8.18)%,均 P<0.05];而 SGRQ、mMRC 及 CAT 评分均显著低于对照组[(28.92±6.23)分比(42.56±8.17)分,(2.24±0.51)分比(2.47±0.49)分,(18.99±4.37)分比(22.25±4.82)分,均 P<0.05];观察组总依从率为94.12%,显著高于对照组的80.39%(χ2=4.320,P<0.05);2 组治疗 3 个月内均未发生严重不良事件,仅观察组出现 2 例(3.92%)恶心、1 例(1.96%)口腔念珠菌感染.结论 Acapella 呼吸训练器联合 EDP 在老年COPD 稳定期患者肺康复中有积极作用.

英文摘要:

      Objective To analyze the application effects of Acapella breathing trainer combined with external diaphragm pacing(EDP)in pulmonary rehabilitation for elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods A total of 102 elderly patients with stable COPD admitted to hospital from January 2024 to December 2024 were selected and divided into two groups according to the random number table method,with 51 cases in each group.The control group received conventional pulmonary rehabilitation training,while the observation group received the Acapella breathing trainer combined with an EDP program.The two groups were compared in terms of pulmonary function,exercise tolerance,quality of life,COPD symptoms and recurrence risk before treatment and three months after treatment.Results Before treatment,there were no statistically significant differences between the two groups in forced expiratory volume in one second(FEV1%),forced vital capacity(FVC),FEV1/FVC ratio,6-minute walk distance(6MWD),Saint George's respiratory questionnaire(SGRQ)score,modified British medical research council(mMRC)dyspnea scale,and COPD assessment test(CAT)score(all P>0.05).After three months of treatment,FEV1%and 6MWD significantly increased in both groups(all P<0.05),while the scores of SGRQ,mMRC and CAT significantly decreased(all P<0.05).After treatment,FEV1%,FVC and FEV1/FVC in the observation group were significantly higher than those in the control group[(41.28±8.85)%vs(33.27±9.13)%,(1.90±0.52)L vs(1.71±0.49)L,(55.29±7.93)%vs(49.28±8.18)%,all P<0.05],while the scores of SGRQ,mMRC and CAT were significantly lower than those in the control group[(28.92±6.23)score vs(42.56±8.17)score,(2.24±0.51)score vs(2.47±0.49)score,(18.99±4.37)score vs(22.25±4.82)score,all P<0.05].The total compliance rate in the observation group was 94.12%,which was significantly higher than that in the control group(80.39%)(χ2=4.320,P<0.05).No serious adverse events occurred in either group within the three-month treatment period.Only the observation group reported two cases(3.92%)of nausea and one case(1.96%)of oral candidiasis.Conclusion The combination of the Acapella breathing trainer and EDP has a positive effect on pulmonary rehabilitation in elderly patients with stable COPD.