Chest:无创间歇正压通气在重度脊柱侧凸运动中的作用

2021-09-17 从医路漫漫 MedSci原创

无创间歇正压通气(NIPPV)可改善COPD患者的运动表现。目前尚不清楚这是否也适用于其他患者群体,如限制性呼吸系统疾病患者。

研究目的:无创间歇正压通气(NIPPV)可改善COPD患者的运动表现。目前尚不清楚这是否也适用于其他患者群体,如限制性呼吸系统疾病患者。

设计:进行一项随机对照试验,有8例严重先天性脊柱侧凸患者参与研究。

干预:通过接口器施加NIPPV,进行次极量平板运动试验。每位受试者随机进行三次行走,使用三个不同的呼吸机呼吸,一次步行通过接口器呼吸,按随机顺序进行。此外,还进行了四次正常无负重的行走呼吸,无需监测。

测量和结果:四次正常无负重的行走没有显示出显着的学习效果。平均步行距离为204米(134.9米)。单独使用接口器,步行距离下降到140米(75.8米),加上呼吸机,步行距离进一步下降到109米(59.3米)。分组效应方差分析显示,不同的步行方式在步行距离上有显著差异(p=0.048)。三种品牌的呼吸机没有差异。在运动的节点,呼吸机辅助步行的潮气量和小潮气量(Mv)与单独使用接口器的步行相比显着增加(p<0.05)。

图1 显示步行距离,与个别数据点和组的平均值。p值使用重复测量的方差分析进行计算。

图2 根据类型、单个数据点和分组平均值显示步行距离。采用混合效应方差分析和按类型比较步行的方法计算p值。

表1 步行运动后的结果

表2 运动节点处的数据

结论:尽管观察到Mv增加,但通过接口器呼吸会减弱运动耐力,并且使用呼吸机呼吸没有改善。NIPPV对严重脊柱侧凸患者的运动耐力有益作用。

原文出处

Highcock MP,  Smith IE,  Shneerson JM,The effect of noninvasive intermittent positive-pressure ventilation during exercise in severe scoliosis.Chest 2002 May;121(5)

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