Evaluation Of The Effect Of Early Lung Rehabilitation Combined With Non-invasive Ventilation On AECOPD Patients

Objective:Pulmonary rehabilitation（PR）is the foundation of comprehensive management of chronic respiratory diseases,which standardizes patient management and promotes long-term adherence to healthy behaviors.In clinical practice,noninvasive ventilator support is currently one of the most important interventions for managing patients with exacerbation of chronic obstructive pulmonary disease（AECOPD）.In this study,early lung rehabilitation training was conducted in AECOPD patients undergoing noninvasive mechanical ventilation,and arterial blood gas analysis and various quality of life indicators were used to assess the feasibility,safety,and effectiveness of early lung rehabilitation training in improving patient diagnosis and prognosis.Method:Fifty non invasive mechanical ventilation（NIV）patients who met the admission criteria for AECOPD in the Fifth Branch of Xinjiang Medical University Hospital from April 2021 to January 2023were randomly divided into a combined treatment group（n=25）and a non invasive ventilation group（n=25）.In addition to routine nursing,the non-invasive ventilation group also underwent routine procedures such as monitoring vital signs,noninvasive ventilation,suppressing cough,and controlling infection.In addition,medication,routine tumbling,back tapping,sputum aspiration,and prone position ventilation were performed in accordance with the treatment principles.On the basis of the non-invasive ventilation group,the pulmonary rehabilitation of patients in the combined treatment group began within 48 hours after admission and continued until discharge.Rehabilitation training includes sports training,breathing training,appropriate nutritional support,targeted psychological support,and health education.After admission and 7 days after the lung rehabilitation program,both groups were subjected to a 30-second Sit-to-Stand Test（30sSTST）,a Modified British Medical Research Council（mMRC）test,a Modified Barthel Index Rating Scale（MBI）scale,and a Chronic Obstructive Pulmonary Disease Assessment Test（CAT）test.Record the indicators of carbon dioxide（PaCO₂）and partial pressure of oxygen（PaO₂）,and count the length of hospitalization of all patients as well as the occurrence of adverse events in the combined treatment group.Statistical evaluation of these seven indicators was conducted to assess the safety,appropriateness,and effectiveness of early lung rehabilitation in this patient group.Result:After 7 days of pulmonary rehabilitation treatment intervention,compared with the non-invasive ventilation group,the arterial PaCO₂in the combined treatment group decreased more significantly（44.55±9.01 mm Hg in the non-invasive ventilation group,53.12±15.49mm Hg in the combined treatment group）,P<0.05,with statistical significance;After 7days of pulmonary rehabilitation treatment intervention,compared with the non-invasive ventilation group,the arterial PaO2 in the combined treatment group increased significantly（94.53±16.46 mm Hg in the combined treatment group,84.46±20.92mm Hg in the non-invasive ventilation group）,P<0.05,with statistical significance;After 7days of lung rehabilitation treatment intervention,compared with the non-invasive ventilation group,the m MRC score in the combined treatment group significantly decreased（2.44±0.71 points in the combined treatment group,2.92±0.49 points in the non-invasive ventilation group）,with a statistically significant difference（P<0.05）;After 7days of lung rehabilitation treatment intervention,compared with the non-invasive ventilation group,the number of 30 second sitting and standing tests（30sSTST）in the combined treatment group increased significantly（7.04±2.67 times in the combined treatment group,2.76±1.62 times in the non-invasive ventilation group）,P<0.05,with statistical significance;After 7 days of lung rehabilitation treatment intervention,compared with the non-invasive ventilation group,the CAT score in the combined treatment group decreased significantly（26.24±5.33 points in the combined treatment group,29.44±4.05 points in the non-invasive ventilation group）,with a statistically significant difference（P<0.05）;After 7 days of lung rehabilitation treatment intervention,compared with the non-invasive ventilation group,the MBI score in the combined treatment group increased significantly（64.96±23.54 points in the combined treatment group,44.92±23.94 points in the non-invasive ventilation group）,with a statistically significant difference（P<0.05）;No adverse events occurred in all patients in the combined treatment group;Conclusion:Early lung rehabilitation improved the carbon dioxide retention of AECOPD patients receiving non-invasive mechanical ventilation.Early lung rehabilitation reduced dyspnea,improved exercise ability,and significantly improved the quality of life and daily activities of AECOPD patients receiving non-invasive mechanical ventilation during hospitalization.For AECOPD patients undergoing noninvasive mechanical ventilation,early lung rehabilitation within 48 hours of admission is feasible and safe,with no side effects.