目的 探讨中重度慢性阻塞性肺疾病（COPD）患者支气管热成形术后德尔菲法肺康复干预临床疗效。方法 选择2021年1月—2023年1月在我院拟行支气管热成形术的82例中重度COPD患者进行研究。对照组支气管热成形术后行常规肺康复,观察组在此基础上加以德尔菲法肺康复。比较2组患者临床疗效、氧合功能、生活质量、病情改善情况、运动耐力、急性加重次数、再入院率及呼吸不良事件发生情况。结果 观察组患者显效率、总有效率分别为82.93%、95.13%,高于对照组的63.41%、85.36%,两组显效、有效、无效等级比较差异有统计学意义。两组二氧化碳分压、呼吸指数和氧合指干预前后差值比较,经t检验,差异均有统计学意义;观察组二氧化碳分压、呼吸指数、氧合指数的干预前后差值均高于对照组。观察组SGRQ、CAT及6MWT干预前后差值差异进行比较,经t检验,差异均有统计学意义;观察组SGRQ、CAT及6MWT干预前后差值均高于对照组。观察组与对照组患者再入院率,差异无统计学意义。观察组患者术后3个月内呼吸相关不良事件发生率低于对照组。结论 中重度COPD患者支气管热成形术后德尔菲法肺康复可有效提高临床疗效,改善患者氧合功能,提高生活质量、改善病情、提高运动耐力,降低急性加重次数及并发症发生率。
Abstract
Objective To explore the clinical efficacy of Delphi pulmonary rehabilitation intervention after bronchial thermoplasty in patients with moderate to severe COPD. Methods 82 patients with moderate to severe COPD in our hospital from January 2021 to January 2023 were selected for study. In the control group, conventional pulmonary rehabilitation was performed after bronchial thermoplasty, and the observation group used Delphi pulmonary rehabilitation on this basis. Compared the clinical efficacy, oxygenation function, quality of life, condition improvement, exercise endurance, number of acute exacerbations, readmission rate and occurrence of respiratory adverse events. Results The apparent efficiency and total efficiency of the patients in the observation group were 82.93% and 95.13% respectively, which were higher than the 63.41% and 85.36% of the control group, and the difference between the two groups was statistically significant when comparing the grades of apparent, effective and ineffective. The difference between the two groups before and after the intervention was statistically significant; The differences of PCO2, respiratory index and oxygenation index before and after intervention in observation group were higher than those in control group. The difference of SGRQ, CAT and 6MWT before and after intervention in the observation group was compared, and the difference was statistically significant after t test; The differences of SGRQ, CAT and 6MWT before and after intervention in the observation group were higher than those in the control group. There was no significant difference in readmission rate between observation group and control group. The incidence of respiratory related adverse events in the observation group was lower than that in the control group 3 months after surgery. Conclusion Delphi pulmonary rehabilitation in patients with moderate to severe COPD can effectively improve clinical efficacy, improve oxygenation function, improve quality of life, improve disease condition, improve exercise endurance, and reduce the number of acute exacerbations and the incidence of complications.
关键词
中重度COPD /
支气管热成形术 /
德尔菲法
Key words
moderate to severe COPD /
bronchoplasty /
Delphi method
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基金
广东省科技计划项目/广东省医学科研基金项目“对中国COPD疾病进展、表型及类型相关临床、影像学以及生物学因素的研究（COMPASS研究）”（2019ZC0014/C2019014）
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