【摘要】：目的:觀察振動正壓呼氣對慢阻肺急性加重患者排痰、肺功能及臨床癥狀的影響方法:選擇2016年09月-2017年03月在我科治療的慢阻肺急性加重患者120例,其中男83例,女37例,年齡47-96歲,平均年齡71.85±9.02歲。所有患者均符合2016慢性阻塞性肺疾病全球倡議(GOLD指南)中慢性阻塞性肺疾病的診斷標準,且符合其中對于急性加重的定義。將患者隨機分為對照組和治療組各60例,對照組予以止咳化痰、解痙平喘及抗感染等常規(guī)治療,治療組在對照組常規(guī)治療基礎上加用振動正壓呼氣裝裝置治療一周。觀察1.兩組患者治療后1-7天痰的變化(痰量、痰液顏色、痰液粘稠度)2.兩組患者治療后肺功能的變化:第一秒用力呼氣容積(FEV1),第一秒用力呼氣容積占預計值的百分比(FEV1%pred)3.兩組患者治療后臨床癥狀評分的改變:慢性阻塞性肺疾病評估測試評分(CAT評分)、轉化呼吸困難指數(shù)評分(TDI評分)。結果:1.治療組患者第1-3天平均排痰量較對照組明顯增多(P0.05);治療組患者第3天痰色評分較對照組明顯低(P0.05);第3天痰液粘稠度較對照組下降顯著(P0.05)2.治療組第3天FEV1及FEV1%pred較對照組升高明顯,升高值比較有統(tǒng)計學意義(P0.05)3.第3天治療組CAT評分下降較對照組明顯,下降值比較有統(tǒng)計學意義(P0.05);第3天TDI評分治療組較對照組升高,升高值比較有統(tǒng)計學意義(P0.05)結論:1.振動正壓呼氣治療法可有效促進慢阻肺急性加重患者排痰2.振動正壓呼氣治療法可改善慢阻肺急性加重患者肺功能3.振動正壓呼氣治療法可改善慢阻肺急性加重患者臨床癥狀
[Abstract]:Objective: to observe the effect of positive vibration expiratory pressure on sputum excretion, pulmonary function and clinical symptoms in patients with acute exacerbation of COPD. Methods: 120 patients with acute exacerbation of COPD treated in our department from September 2016 to March 2017 were selected, including 83 males and 37 females. The average age was 71.85 鹵9.02 years. All patients met the diagnostic criteria of the 2016 Global Initiative for chronic obstructive Pulmonary Disease (GOLD) and the definition of acute exacerbation. The patients were randomly divided into control group (n = 60) and treatment group (n = 60). The control group was treated with routine treatment such as relieving cough and resolving phlegm, spasmolysis and anti-infection. The treatment group was treated with positive vibratory expiratory device for one week on the basis of routine treatment in the control group. Observation 1. The changes of sputum (sputum volume, sputum color, sputum viscosity) in both groups were 1-7 days after treatment. Changes in pulmonary function after treatment: forced expiratory volume in the first second (FEV1) and forced expiratory volume in the first second as a percentage of the predicted value (FEV1%pred). The changes of clinical symptom score after treatment: chronic obstructive pulmonary disease assessment test score (CAT), transforming dyspnea index score (TDI score). Results: 1. The average amount of sputum excretion in the treatment group was significantly higher than that in the control group on the 1-3 day (P0.05); the phlegm color score on the 3rd day in the treatment group was significantly lower than that in the control group (P0.05); the viscosity of sputum in the treatment group was significantly lower than that in the control group (P0.05) on the 3rd day (P0.05). FEV1 and FEV1%pred in the treatment group were significantly higher than those in the control group on day 3 (P0.05). On the 3rd day, the CAT score in the treatment group was significantly lower than that in the control group (P0.05), and the TDI score in the treatment group was higher than that in the control group on the 3rd day (P0.05). Conclusion: 1. Positive vibratory expiratory therapy can effectively promote sputum excretion in patients with acute exacerbation of COPD. Positive vibratory expiratory therapy can improve pulmonary function in patients with acute exacerbation of COPD. Positive vibratory expiratory therapy can improve clinical symptoms in patients with acute exacerbation of COPD
【學位授予單位】：揚州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R563.9

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