Therapeutic Effect Of Ong-term Oxygen Therapy Combined With Pulmonary Rehabilitation Exercise On Chronic Obstructive Pulmonary Disease Combined With Pulmonary Heart Disease

Objective:To explore the clinical effect of long-term oxygen therapy combined with pulmonary rehabilitation exercise in patients with chronic obstructive pulmonary disease(copd)combined with pulmonary heart disease(cor pulmonale)in stable period,and to provide basis and reference for clinical diagnosis and treatment.Methods:74 cases of patients with chronic obstructive pulmonary disease(copd)complicated by pulmonary heart disease(CWD)in outpatient and inpatient treatment from December 2017 to May 2019 were selected as objects,and randomly divided into control group(n=37 cases)and observation group(n=37 cases).After admission,both groups were given conventional treatment,while the control group was given long-term oxygen therapy,and the observation group was combined with pulmonary rehabilitation exercise on the basis of the control group,and the therapeutic effect of the patients was evaluated after 8 weeks of treatment.Lung function levels of the two groups(including:vital capacity(VC),forced vital capacity(FVC),ratio of forced expiratory volume in the first second to the estimated value(fev1%pred)and FEV1/FVC level)were measured by the lung function analyzer produced by jaeger.Germany.The partial pressure of blood oxygen(PaO2),partial pressure of carbon dioxide(PaCO2)and PH of the two groups were measured by blood gas analyzer.Exercise endurance of the two groups was measured by 6min walking distance.The quality of life of the two groups was assessed by st.George respiratory questionnaire score(SGRQ).Phlilps Sonos550 color doppler ultrasound was used to determine pulmonary systolic blood pressure and cardiac Tei index in the two groups.The levels of d-dimeric(d-d),erythrocyte volume(Hct),serum troponin(CTnI)and brain natriuretic peptide(BNP)in the two groups were determined by automatic biochemical analyzer.All data in this study were processed by SPSS 17.0 software.Results:(1)the ratio of VC,FVC and FEV1 to the predicted value and the level of FEV1/FVC in the two groups 8 weeks after treatment were all higher than that before treatment(P<0.05).The ratio of pulmonary function VC,FVC and FEV1 to the predicted value and the level of FEV1/FVC in the observation group were all higher than those in the control group at 8 weeks after treatment(P<0.05).(2)there was no significant difference in PaO2 and PH levels between the observation group and the control group at 8 weeks after treatment(P>0.05).8 weeks after treatment,PaCO2 level in the observation group was lower than that in the control group(P<0.05).(3)the number of grade III and IV exercise endurance cases in the observation group 8 weeks after treatment was higher than that in the control group(P<0.05).The number of grade I and II exercise endurance cases in the observation group after 8 weeks of treatment was lower than that in the control group(P<0.05).(4)SGRQ scores of observation group and control group at 1,2,4 and 8 weeks after treatment were lower than those before treatment(P<0.05).SGRQ scores at 1,2,4 and 8 weeks after treatment in the observation group were lower than those in the control group(P<0.05).(5)pulmonary artery systolic blood pressure and heart Tei index were lower than those before treatment at 8 weeks after treatment in both groups(P<0.05).Pulmonary artery systolic pressure and heart Tei index in the observation group were lower than those in the control group at 8 weeks after treatment(P<0.05).(6)the levels of d-d,Hct,CTnI and BNP at 8 weeks after treatment were lower than those before treatment(P<0.05).The levels of d-d,Hct,CTnI and BNP in the observation group at 8 weeks after treatment were lower than those in the control group(P<0.05).Conclusion:(1)long-term oxygen therapy combined with pulmonary rehabilitation exercise can achieve relatively high short-term efficacy in patients with chronic obstructive pulmonary disease combined with pulmonary heart disease at the stable stage,which is conducive to improving patients' pulmonary function level,blood and gas level,enhancing patients' exercise endurance and improving patients' life quality;(2)long-term oxygen therapy combined with pulmonary rehabilitation exercise can improve pulmonary systolic blood pressure and cardiac function in patients with chronic obstructive pulmonary disease and pulmonary heart disease,and improve the level of biochemical indicators in patients,which is worthy of promotion and application.