Clinical sigrificance of early lung rehabilitation training in mechanical ventilation treatment of AECOPD patients

doi:10.3877/cma.j.issn.1674-6902.2022.01.010

Abstract

Abstract:

Objective

To explore the effect of early lung rehabilitation training on mechanical ventilation in patients with AECOPD.

Methods

72 patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD) hospitalized in the department of respiratory and critical care medicine of our hospital from May 2020 to October 2021 were randomly divided into observation group 37 cases and control group 35 cases. The control group was treated with anti infection, expectorant, antispasmodic and ventilator support. On this basis, the observation group was given limb training, inspiratory muscle resistance and active respiratory and circulatory training from mechanical ventilation. PaO₂, PaCO₂, pH and lactic acid were measured. The incidence of lower extremity venous thrombosis, mechanical ventilation time, average length of stay in ICU and the incidence of ventilator-associated pneumonia were observed.

Results

The incidence of lower extremity venous thrombosis(5.76% vs. 20.00%), mechanical ventilation time(11.40±1.32 vs. 14.46±1.86)d, average length of stay in ICU (16.15±1.93 vs. 18.55±2.34)d and the incidence of ventilator-associated pneumonia (9.61% vs. 26.00%)in the observation group were better than those in the control group (P<0.05). On the 5 th day(44.07±11.00 vs. 52.89±5.52)mmHg and 10 th day(41.87±3.96 vs. 45.22±3.30)mmHg, the node PaCO₂ of the observation group was lower than that of the control group, while the pH value, SaO₂ and PaO₂ were higher than those of the control group (P<0.05).

Conclusion

Early pulmonary rehabilitation training for patients with AECOPD mechanical ventilation can significantly improve the blood gas indexes of patients with COPD. Reduce the occurrence of complications and promote the early recovery of patients.

Key words: Acute exacerbation of chronic obstructive pulmonary disease, Mechanical ventilation, Breathing exercises, Pulmonary rehabilitation, Clinical significance

Jing Wu, Yuhong Tian, Panpan Li, Jiguang Meng. Clinical sigrificance of early lung rehabilitation training in mechanical ventilation treatment of AECOPD patients[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2022, 15(01): 42-46.

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组　别	例数	治疗前/后	乳酸(mmol/L)	pH	PaCO₂(mmHg)	PaO₂(mmHg)
观察组	37	治疗前	6.52±0.33	7.27±0.18	66.13±7.36	54.77±5.77
		治疗5 d	4.51±0.34^a	7.35±0.16^a	44.07±11.00^a	79.98±4.66^a
		治疗10 d	3.68±0.40^a	7.45±0.22^a	41.87±3.96^a	86.47±4.77^a
对照组	35	治疗前	6.52±0.33	7.27±0.19	66.37±7.11	54.54±5.86
		治疗5 d	4.67±0.34^a	7.25±0.134^a	52.89±5.52^a	75.82±4.57^a
		治疗10 d	3.92±0.45^a	7.35±0.07^a	45.22±3.30^a	83.49±5.33^a

组　别	例数	治疗前/后	乳酸(mmol/L)	pH	PaCO₂(mmHg)	PaO₂(mmHg)
观察组	37	治疗前	6.52±0.33	7.27±0.18	66.13±7.36	54.77±5.77
		治疗5 d	4.51±0.34^a	7.35±0.16^a	44.07±11.00^a	79.98±4.66^a
		治疗10 d	3.68±0.40^a	7.45±0.22^a	41.87±3.96^a	86.47±4.77^a
对照组	35	治疗前	6.52±0.33	7.27±0.19	66.37±7.11	54.54±5.86
		治疗5 d	4.67±0.34^a	7.25±0.134^a	52.89±5.52^a	75.82±4.57^a
		治疗10 d	3.92±0.45^a	7.35±0.07^a	45.22±3.30^a	83.49±5.33^a

组　别		例数	血栓发生率[n(%)]	有创通气时间(d)	总机械通气时间(d)	ICU住院时间(d)	VAP发生率[n(%)]
观察组		37	3(5.76)	9.64±1.19	11.40±1.32	16.15±1.93	5(9.61)
对照组		35	10(20.00)	11.55±1.37	14.46±1.86	18.55±2.34	13(26.00)
	t或χ²		4.002	14.036	18.019	8.040	4.709
	P值		0.045	0.000	0.001	0.000	0.030

组　别		例数	血栓发生率[n(%)]	有创通气时间(d)	总机械通气时间(d)	ICU住院时间(d)	VAP发生率[n(%)]
观察组		37	3(5.76)	9.64±1.19	11.40±1.32	16.15±1.93	5(9.61)
对照组		35	10(20.00)	11.55±1.37	14.46±1.86	18.55±2.34	13(26.00)
	t或χ²		4.002	14.036	18.019	8.040	4.709
	P值		0.045	0.000	0.001	0.000	0.030

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