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| Application of External Diaphragm Pacemaker Combined with Resistance Breathing Training in Patients with Chronic Obstructive Pulmonary Disease and Respiratory Failure |
| WANG Xialing, YANG Yang, ZHANG Yan |
| The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Hohhot 010030, China |
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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.
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[1] Christenson SA,Smith BM,Bafadhel M,et al.Chronic obstructive pulmonary disease[J].Lancet,2022,399(10342):2227-2242.
[2] 汪海燕,周敏,汤琪琳,等.缩唇呼吸训练联合拍背咳痰法对胸腔镜肺癌根治术后患者肺功能康复和术后并发症的影响[J].西部中医药,2022,35(8):143-146.
[3] 苏鑫,梁冬.体外膈肌起搏器在呼吸衰竭中的临床应用进展[J].中国医药导报,2024,21(10):193-195.
[4] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组,中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会.慢性阻塞性肺疾病诊治指南(2021年修订版)[J].中华结核和呼吸杂志,2021,44(3):170-205.
[5] 李安慈.中药穴位贴敷辅助治疗慢性阻塞性肺疾病急性加重期伴呼吸衰竭临床研究[J].新中医,2020,52(11):114-117.
[6] 柳涛,蔡柏蔷.慢性阻塞性肺疾病诊断、处理和预防全球策略(2011年修订版)介绍[J].中国呼吸与危重监护杂志,2012,11(1):1-12.
[7] 廖春燕,徐丹,王娜娜.Th17/Treg细胞比例、诱导型一氧化氮合酶基因多态性与慢性阻塞性肺疾病患者脏腑虚损的相关性研究[J].中国现代医学杂志,2022,32(7):65-70.
[8] He C,Ren S,Du Q,et al.Adjuvant therapy:yiqiditan tongfu decoction with external diaphragm pacer for chronic obstructive pulmonary disease patients with difficulty weaning from mechanical ventilation[J].Altern Ther Health Med,2020,26(3):32-38.
[9] 陈绪池,黄娟,刘畅,等.体外膈肌起搏治疗对慢性阻塞性肺病急性加重期患者内环境的影响[J].四川医学,2023,44(6):570-574.
[10] 梁毅.体外膈肌起搏器联合呼吸反馈在脑卒中后气管切开病人肺康复中的应用效果[J].护理研究,2021,35(15):2792-2794.
[11] 冯习,黄方舟,李伟,等.体外膈肌起搏联合纤维支气管镜肺泡灌洗治疗在慢性阻塞性肺疾病有创机械通气患者中的应用效果[J].广西医学,2023,45(14):1653-1657. |
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2025, Vol. 31 
