吴金芳,湛维峄,刘剑南,等.经鼻高流量湿化氧疗联合呼吸训练对高龄慢性阻塞性肺疾病合并慢性呼吸衰竭患者呼吸功能的影响[J].中华物理医学与康复杂志,2026,48(6):521-525
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| 经鼻高流量湿化氧疗联合呼吸训练对高龄慢性阻塞性肺疾病合并慢性呼吸衰竭患者呼吸功能的影响 |
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| DOI：10.3760/cma.j.cn421666-20250716-00596 |
| 中文关键词: 呼吸训练 经鼻高流量湿化氧疗 高龄 慢性阻塞性肺疾病 呼吸衰竭 |
| 英文关键词: Respiration training High-flow oxygen therapy Elderly Chronic obstructive pulmonary disease Respiratory failure |
| 基金项目:江苏省卫生健康委预防医学科研项目（Yl2023047） |
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| 中文摘要: |
| 目的 观察经鼻高流量湿化氧疗联合呼吸训练对高龄慢性阻塞性肺疾病（COPD）合并慢性呼吸衰竭患者呼吸功能的影响。 方法 将80例高龄COPD合并慢性呼吸衰竭患者按随机数字表法分为对照组和观察组，每组40例。2组患者均给予常规治疗及经鼻高流量湿化氧疗，观察组在此基础上增加呼吸训练。治疗前及治疗4周后（治疗后），使用血气分析仪检测2组患者机体的酸碱度（pH）、动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2），采用肺功能检测仪测定第1秒用力呼气容积（FEV1）、呼气峰值流速（PEF）、第1秒用力呼气容积与用力肺活量的比值（FEV1/FVC），并利用慢性阻塞性肺疾病评估测试（CAT）和世界卫生组织生存质量测定量表简表（WHOQOL-BREF）对患者的症状严重程度和生存质量进行评估。 结果 治疗后，2组患者的pH、PaO2水平、PaCO2水平、CAT评分、WHOQOL-BREF评分均较组内治疗前改善（P<0.05），观察组FEV1、FEV1/FVC、PEF较组内治疗前改善（P<0.05）。与对照组比较，观察组治疗后的pH（7.406±0.139）较高、PaO2水平［（70.50±1.63）mmHg］较高、PaCO2水平［（49.40±1.03）mmHg］较低、FEV1［（1.38±0.21）L］较高、FEV1/FVC［（66.20±2.21）%］较高、PEF［（243.00±8.07）L/min］较高、CAT评分［（18.88±2.28）分］较低，差异有统计学意义（P<0.05）。 结论 经鼻高流量湿化氧疗联合呼吸训练能够改善高龄COPD合并慢性呼吸衰竭患者的血气指标、肺功能及生存质量。 |
| 英文摘要: |
| Objective To observe any effect of supplementing high-flow nasal cannula oxygen therapy with respiration training in the treatment of very elderly patients with chronic obstructive pulmonary disease (COPD) and chronic respiratory failure. Methods Eighty very elderly patients with COPD and chronic respiratory failure were randomly divided into a control group and an observation group, each of 40. Both groups received conventional treatment and high-flow nasal cannula oxygen therapy for 4 weeks, but the observation group also received respiration training. Before and after the treatment, blood pH, arterial partial pressure of oxygen (PaO2), and arterial partial pressure of carbon dioxide (PaCO2) were recorded. Forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) were also measured. The COPD assessment test (CAT) and the World Health Organization′s Quality of Life-BREF (WHOQOL-BREF) instrument were employed to assess the severity of the subjects′ symptoms and their life quality. Results Both groups′ average pH level, PaO2, PaCO2, CAT score and WHOQOL-BREF score had improved significantly. In the observation group, the average FEV1, FEV1/FVC and PEF had also improved significantly. Compared with the control group, the observation group then showed significantly higher average pH, PaO2, FEV1, FEV1/FVC and PEF values, but a significantly lower average PaCO2 and CAT score. Conclusions Supplementing respiration training with high-flow oxygen through a nasal cannula can more effectively improve the blood gas indices, lung function and the life quality of very elderly patients with COPD and chronic respiratory failure. |
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