Effect Of NPPV On Pulmonary Rehabilitation In Patients With Severe Stable Chronic Obstructive Pulmonary Disease

Objective:To explore the effect of non-invasive positive pressure ventilation on pulmonary rehabilitation in patients with severe stable chronic obstructive pulmonary disease,and provide a safe and reliable rehabilitation treatment for patients with stable chronic obstructive pulmonary disease.Method:A total of 56 patients with severe stable chronic obstructive pulmonary disease who had undergone regular treatment at the Department of Respiratory Medicine from February 2016 to November 2017 were randomly selected and divided into a control group and NPPV group.Oxygen therapy and routine therapy were given to the control group.In the comprehensive treatment,NPPV group received noninvasive positive pressure ventilation on the basis of the control group.Observe the follow-up patient's 2months,6 months each index changes(including HR,RR,PaCO_2,PaO₂,mMRC score,SAMU score,SGRQ score,6MWT,etc.),comprehensive evaluate the effect of NPPV on moderate to severe stable COPD patients'pulmonary rehabilitation.Result:There was no death and serious complications occurred during the clinical trial,but5 patients were lost due to transferred and poor compliance,26 cases in the control group and 25 cases in NPPV group were included in the statistical analysis.The two groups had no statistical difference in age,gender,RR,HR,PaCO₂,PaO₂,mMRC score,SGRQ score,SAMU score,and 6MWT?P>0.05?.1.physiological indexes:?1?The RR and HR of the two groups decreased after treatment for 2 months,and they were significantly lower in the NPPV group?P<0.05?;?2?RR and HR of the two groups after 6 months of treatment All decreased compared with before treatment,and the NPPV group decreased more significantly?P<0.05?.?3?RR and HR decreased gradually with the prolongation of treatment time,indicating that there was a difference between the different time before and after treatment and the difference was statistically significant?P<0.001?,both in the NPPV group and the control group.2.blood gas analysis:?1?After 2 months of treatment,PaO₂ increased,PaCO₂decreased,and the effect of The NPPV group was more obvious in the two groups than before treatment?P<0.05?;?2?PaO₂ increased and PaCO₂ decreased in the two groups after 6 months of treatment The NPPV group was significantly higher than the control group?P<0.05?.?3?As the treatment time prolonged,PaO₂ gradually increased and PaCO₂gradually decreased,indicating that there was a difference between the different time before and after treatment and the difference was statistically significant?P<0.001?,both in the NPPV group and the control group.3.The index of the rating scale:?1?mMRC score:?1?After 2 months of treatment,the mMRC scores in both groups were lower than those before treatment,and the NPPV group was more significantly lower?P<0.05?;?2?The mMRC scores were lower in both groups after 6 months of treatment than before treatment,and NPPV group was lower than that before treatment.The reduction was more significant in the group?P<0.05?;?3?The mMRC score decreased gradually with the prolongation of treatment time,which indicated that there was a difference between the time before and after treatment and the difference was statistically significant?P<0.001?,both in the NPPV group and the control group.?2?SAMU score:?1?After 2 months of treatment,the SAMU scores of both groups were lower than those before treatment,and were significantly lower in the NPPV group?P<0.05?;?2?SAMU scores were lower in the two groups after 6 months of treatment than before treatment,and NPPV group was lower in the two groups.The group decreased more significantly?P<0.05?;?3?As the treatment time prolonged,the SAMU score gradually decreased,indicating that the time before and after treatment was different and the difference was statistically significant?P<0.001?,both in the NPPV group and the control group.?3?SGRQ score:?1?SGRQ scores decreased after two months of treatment in both groups compared with before treatment,and were significantly lower in the NPPV group?P<0.05?;?2?SGRQ scores were lower in both groups after 6 months of treatment than before treatment,and NPPV group was lower than that before treatment.The decrease was more significant in the group?P<0.05?;?3?The SGRQ score decreased gradually with the prolongation of treatment time,which indicated that there was a difference between the time before and after treatment and the difference was statistically significant?P<0.001?,both in the NPPV group and the control group.4.6MWD:?1?After 6 months of treatment,the 6MWD in the two groups were all higher than before,and the NPPV group was significantly higher?P<0.05?,and 6MWD was higher after 6 months of treatment than after 2 months of treatment.The amplitude was more?P<0.05?;?2?The 6MWD gradually increased with the prolongation of treatment time,which indicated that there were differences between the two treatments before and after treatment and the difference was statistically significant?P<0.001?.The NPPV group and the control group were both in this way.Conclusion:Non-invasive positive pressure ventilation treatment can effectively improve the patient's physiological indicators?HR,RR?,blood gas analysis?PaCO₂,PaO₂?,improve the patients'mMRC score,SAMU score,SGRQ Grading,improve the walking distance by 6minutes,improve the patients'condition from the four aspects of physiological indicators,symptoms,quality of life,exercise tolerance in patients with stable chronic obstructive pulmonary disease.