| 徐路,李刚,干益敏,等.体外膈肌起搏联合吸气肌训练对慢性阻塞性肺疾病急性加重病人动脉血气指标、呼吸力学参数及氧化应激反应的影响[J].安徽医药,2021,25(4):777-781. |
| 体外膈肌起搏联合吸气肌训练对慢性阻塞性肺疾病急性加重病人动脉血气指标、呼吸力学参数及氧化应激反应的影响 |
| Effects of external diaphragmatic pacing combined with inspiratory muscle training on arterial blood gas parameters, respiratory mechanical parameters,and oxidative stress response in patients with AECOPD |
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| DOI：10.3969/j.issn.10096469.2021.04.035 |
| 中文关键词: 肺疾病，慢性阻塞性 呼吸锻炼 电刺激疗法 体外膈肌起搏 临床疗效 |
| 英文关键词: Pulmonary disease, chronic obstructive Breathing exercises Electric stimulation therapy External diaphragm pacing Clinical efficacy |
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| 中文摘要: |
| 目的探讨体外膈肌起搏联合吸气肌训练对慢性阻塞性肺疾病急性加重(AECOPD)病人动脉血气指标、呼吸力学参数及氧化应激反应的影响。方法从 2016年 1月至 2018年 8月在徐州医科大学附属淮安医院收治的病人中随机选择满足研究条件的 AECOPD住院病人 132例进行研究。采用随机数字表法分为 3组，各 44例。 A组行常规药物治疗。待病情稳定后 B组在常规治疗基础上行吸气肌训练，每日早晚各 1次， 30分钟 /次。 C组在常规治疗及吸气肌训练的基础上加以体外膈肌起搏， 30分钟 /次， 2次/日， B组与 C组病人康复疗程均为 20 d。对比 3组病人临床疗效、动脉血气指标、呼吸力学参数及氧化应激反应指标。结果 C组病人总有效率为 95.45%，高于 A组与 B组的 61.36%及 81.82%，且 B组总有效率高于 A组(P<0.05)。治疗前 3组病人二氧化碳分压(PaCO2)(65.95±6.11)比(66.74±5.97)比(67.03±6.05)mmHg及氧分压(PaO2)(55.18±6.81)比(56.19±7.25)比(55.96±6.93)mmHg均差异无统计学意义(P>0.05)，(53.19±7.94)比(49.06±7.71)比(45.58±6.84)mmHg水治疗后 PaCO2平呈 A组>B组>C组趋势， PaO2(59.16±8.90)比(63.04±8.41)比(66.58±7.93)mmHg水平呈 A组0.05)，治疗后 3组气道峰压(31.68±8.11)比(28.15±7.82比(24.83±6.91)cmH2O、呼吸压力(23.26±6.29)比(20.52±5.83)比(18.06±4.71)cmH2O及气道阻力(34.19±5.58)比(31.25±5.39)比(29.04±4.91)cmH2O·L-1·s-1均呈 A组>B组>C组趋势(P<0.05)。治疗前 3组 MDA(7.08±2.11)比(7.15±2.18)比(7.10±2.20)μmol/L、超氧化物歧化酶(SOD)(72.24±4.61)比(72.05±4.82)比(71.80±5.03)Nu/mL及谷胱甘肽(GSH)(219.04±15.74)比(220.15±16.17)比(218.47±15.83)mg/L均差异无统计学意义(P>0.05)治疗后血清丙二醛(MDA)(5.81±1.29)比(5.23±1.30)比(4.68±1.14)μmol/L水平呈 A组>B组>C组趋势， SOD(76.84±5.94)9.39±5.88)比(82.19±6.21) Nu/mL及 GSH(229.21±17.65)比(237.04±18.30)比(245.07±19.18)mg/L水平呈 A组 |
| 英文摘要: |
| Objective To investigate the effects of external diaphragmatic pacing combined with inspiratory muscle training on arterial blood gas parameters, respiratory mechanical parameters, and oxidative stress response in patients with Acute exacerbation ofchronic obstructive pulmonary disease (AECOPD).Methods One hundred and thirty-two patients with AECOPD who met the studyconditions were randomly selected from patients admitted to Huai'an Hospital Affiliated to Xuzhou Medical University from January2016 to August 2018 for study. Random number table method was used to divide the patients into 3 groups with 44 cases in each group.Group A received routine drug therapy; group B received inspiratory muscle training on the basis of routine treatment, once a day in themorning and once a day in the evening, 30 min a time; group C received external diaphragm pacing on the basis of routine treatmentand inspiratory muscle training, 30 min a time, twice a day, and the rehabilitation courses of group B and group C were all 20 days. Theclinical efficacy, arterial blood gas parameters, respiratory mechanics parameters, and oxidative stress response indicators of the 3groups of patients were compared.Results The total effective rate of patients in group C was 95.45%, which was higher than that ofgroups A and B (61.36% and 81.82%), and the total effective rate of group B was higher than that of group A (P<0.05). There was no significant difference in Partial pressure of carbon dioxide in artery (PaCO2) (65.95±6.11 vs. 66.74±5.97 vs. 67.03±6.05) mmHg and Partial pressure of oxygen (PaO2) (55.18±6.81 vs. 56.19±7.25 vs.55.96±6.93)mm Hgamong the thre egroupsbe foretrea tment (P>0.05). After treatment, PaCO2 level (53.19±7.94 vs. 49.06±7.71 vs.45.58±6.84) mmHg showed a trend of group A>group B> group C, and PaO2 level (59.16±8.90 vs. 63.04±8.41 vs. 66.58±7.93) mmHg showed a trend of group A < group B < group C (P<0.05). There was no significant difference in peak airway pressure (32.90±9.11 vs. 33.78±9.25 vs. 33.62±8.93) cmH2O, respiratory pressure (26.85±6.88 vs. 27.38±6.91 vs. 27.25±6.70) cmH2O and airway resistance (37.10±6.26 vs. 37.61±6.18 vs. 37.27±5.94) cmH2O·L-1·s-1 among the three groups before treatment (P>0.05). After treatment, the peak airway pressure (31.68±8.11 vs. 28.15±7.82 vs. 24.83±6.91) cm H2O, respiratory pressure (23.26±6.29 vs. 20.52±5.83 vs. 18.06±4.71) cmH2O and airway resistance (34.19±5.58 vs. 31.25±5.39 vs. 29.04±4.91) cmH2O·L-1·s-1of the three groups showed a trend of group A>group B>group C (P<0.05). There was no significant difference in Malonaldehyde (MDA) (7.08±2.11 vs. 7.15±2.18 vs. 7.10±2.20) μmol/L, Superoxide dismutase (SOD) (72.24±4.61 vs. 72.05±4.82 vs 71.80± 5.03) Nu·mL-1and Glutathione (GSH) (219.04±15.74 vs. 220.15±16.17 vs. 218.47±15.83) mg·L-1among the three groups before treatment (P>0.05). After treatment, MDA level (5.81±1.29 vs. 5.23±1.30 vs. 4.68±1.14) μmol/L showed a trend of group A>group B>group C, SOD (76.84±5.94 vs. 79.39±5.88 vs. 82.19±6.21) Nu/mL and GSH level (229.21±17.65 vs. 237.04±18.30 vs. 245.07±19.18) mg/L showed a trend of group A< group B |
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