缩唇腹式呼吸联合阻力呼吸训练器对老年慢性阻塞性肺病稳定期患者康复效果和生活质量的影响

摘要

目的 观察缩唇腹式呼吸联合阻力呼吸训练器对老年慢性阻塞性肺病(COPD)稳定期患者康复效果和生活质量的影响.方法 将2017年1~7月我院收治的120例老年COPD稳定期病例纳入研究,按照随机原则分为研究组和对照组各60例,对照组开展缩唇腹式呼吸训练,研究组予以缩唇腹式呼吸联合阻力呼吸训练器方案,比较两组训练前后肺功能[1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、FEV1/预计值(FEV1% pred)]、血气分析[血二氧化碳分压(PaCO2)与氧分压(PaO2)]、呼吸肌生理学[最大呼气压(MEP)与最大吸气压(MIP)]、6 min步行距离(6 MWT)、生活质量(SF-36)评分.结果 训练后,研究组FEV1、FVC、FEV1/FVC及FEV1% pred均明显高于对照组(P<0.05);血PaCO2明显低于对照组(P<0.05),PaO2、MEP、MIP明显高于对照组(P<0.05);6 MWT明显大于对照组(P<0.05),SF-36量表中各项内容评分明显高于对照组(P<0.05).结论 缩唇腹式呼吸联合阻力呼吸训练器能有效改善老年COPD稳定期患者血气分析,促进肺功能与呼吸功能的恢复,增加患者运动耐力,同时提高其生活质量,具有积极意义.%Objective To observe the effects of half-closed lip abdominal respiration combined with resistance breathing train-ing device on rehabilitation and quality of life in elderly patients with chronic obstructive pulmonary disease (COPD) at stable stage. Methods One hundred and twenty COPD elderly patients at stable stage treated in our hospital from January 2017 to July 2017 were included in the study.They were randomly divided into control or study group with 60 cases in each group.The control group was given half-closed lip abdominal respiration training,and the study group was given the scheme of half-closed lip abdominal respiration com-bined with resistance breathing training device. The levels of pulmonary functions such as forced expiratory volume in one second (FEV1),forced vital capacity (FVC),FEV1/FVC ratio and FEV1/predicted value (FEV1% pred),the blood gas analysis such as blood carbon dioxide partial pressure (PaCO2) and oxygen partial pressure (PaO2),the respiratory muscle physiology such as maxi-mum expiratory pressure (MEP) and maximum inspiratory pressure (MIP),the 6 min walking distance (6 MWT) and quality of life (SF-36) score were compared between the two groups before and after training.Results After training,the levels of FEV1,FVC, FEV1/FVC and FEV1% were significantly higher in the study group than those in the control group(P<0.05).The blood PaCO2level of the study group was lower while the levels of PaO2,MEP and MIP were significantly higher than those of the control group(all P<0.05).The 6 MWT level in the study group was significantly higher than that in the control group(P<0.05),and the all scores in the SF-36 scale were significantly higher than those in the control group (P<0.05).Conclusion Half-closed lip abdominal respiration combined with resistance breathing training device can effectively improve the blood gas status and the recovery of lung function,and in-crease patient endurance as well as the quality of life in elderly patients with stable COPD.Therefore,it has active implementation sig-nificance.