震荡呼气末正压治疗对支气管扩张患者肺功能及生活质量的影响

冯望 王小琳 蒋幼凡 李佳佳 陈贵华

[摘要]目的支气管扩张常伴随气管内黏液痰栓形成和合并感染。震荡呼气末正压治疗常用于肺功能差患者的呼吸康复，本研究旨在探索该技术对于支气管扩张患者肺功能和生活质量的影响。方法本试验为随机对照试验。选取2017年9月至2018年9月期间在重庆医科大学附属第二医院接受治疗的98例支气管扩张患者，采用简单随机抽样法将研究对象分为对照组和试验组，每组各49例。对照组予以常规治疗，试验组在此基础上给予震荡呼气末正压治疗。于治疗前后测定两组患者的肺功能指标、炎性指标及生活质量评分。结果两组治疗后肺功能指标、生活质量评分均高于治疗前，且炎性指标均低于治疗前，差异有统计学意义（ P <0.05）;試验组肺功能指标、生活质量评分均高于对照组，炎性指标低于对照组，差异有统计学意义（ P <0.05）。结论震荡呼气末正压治疗可更加有效地改善支气管扩张患者肺功能，减轻炎性反应，提升患者生活质量。

[关键词]震荡呼气末正压治疗;支气管扩张;肺功能;炎症因子;生活质量评分

[中图分类号] R562.2 [文献标识码] A  [文章编号]2095-0616（2021）22-0181-04

Effect of oscillating positive end-expiratory pressure therapy on pulmonary function  and  quality  of life  in patients with bronchiectasis

FENG  WangWANGXiaolin   JIANG  Youfan   LI  Jiajia   CHEN  Guihua

The Second Affiliated Hospital of Chongqing Medical University， Chongqing 400042， China

[Abstract] Objective Bronchiectasis is generally accompanied by the formation of mucus sputum thrombus in trachea and infection. The oscillating positive end-expiratory pressure （OSCPEP） therapy is often used for respiratory rehabilitation of patients with poor pulmonary function. The purpose of this study was to explore the effect of this technique on pulmonary function and quality of life of patients with bronchiectasis. Methods This experiment was a randomized controlled experiment. A total of 98 patients with bronchiectasis treated in the Second Affiliated Hospital of Chongqing Medical University from September 2017 to September 2018 were collected. The subjects were randomly divided into the control group and the experimental group， with 49 cases in each group. The control group was given routine treatment， and the experimental group was given OSCPEP on the basis of this. Before and after treatment， the pulmonary function index， inflammatory index and quality of life score of the two groups were measured. Results After treatment， the lung function index and quality of life score of the two groups were higher than those before treatment， and the inflammatory index was lower than that before treatment， with statistically significant differences （P <0.05）. The pulmonary function index and quality of life score of the experimental group were higher than those of the control group， while the inflammatory index was lower than that of the control group， with statistically significant differences （P <0.05）. Conclusion OSCPEP therapy can effectively improve the pulmonary function of patients with bronchiectasis， reduce inflammatory reaction and improve their quality of life.

[Key words] Oscillatory positive end-expiratory pressure therapy; Bronchiectasis; Pulmonary function; Inflammatory factors; Quality of life score

支气管扩张是一种常见的慢性呼吸道疾病，其病理表现为支气管及其周围肺组织慢性化脓性炎症和纤维化，常伴随扩张支气管内黏液痰栓形成。由于易反复合并感染，从而破坏支气管壁，使其发生变形和扩张[1-2]。临床上目前出现震荡呼气末正压治疗的方案，患者通过吹气，直接带动气道振動，使黏附在气道内的分泌物松动，从气道表面脱离，同时呼气时产生正压扩张气道，将松解的分泌物自下而上推入上部大气道，便于患者咳嗽排出。此方法用于清除患者呼吸道痰液，消除患者支气管炎症[3-4]。……