摘要
目的探讨下颏抗阻力训练(CTAR)对阻塞性睡眠呼吸暂停(OSA)并慢性阻塞性肺疾病(COPD)患者肺通气功能、口咽部位形态及多导睡眠监测参数的影响。方法选取2019-01-01-2020-08-31郑州大学第一附属医院收治的105例OSA-COPD患者作为研究对象,按随机数字表法分为对照组(n=52)和观察组(n=53)。对照组给予强化肺康复训练,观察组在对照组基础上增加CTAR,对比2组患者的多导睡眠监测、口咽部位形态指标与肺通气功能。结果干预12周后,观察组的呼吸暂停低通气指数(AHI)为(14.08±3.72)次/h,对照组的为(17.26±4.25)次/h,均低于干预前,且观察组低于对照组,F=6.175,P=0.015;夜间血氧饱和度<90%时间占总睡眠时间比值(TST90)为(21.33±6.11)%,对照组的为(30.26±8.04)%,均低于干预前,且观察组低于对照组,F=39.424,P<0.001;夜间最低血氧饱和度(LowSpO_(2))为(83.52±8.04)%,对照组的为(76.59±7.20)%,均高于干预前,且观察组高于对照组,F=20.437,P<0.001。观察组的腭后距离为(0.42±0.12)cm,对照组的为(0.34±0.11)cm,均大于干预前,且观察组大于对照组,F=11.774,P=0.001;舌后距离为(2.08±0.26)cm,对照组的为(1.90±0.30)cm,均大于干预前,且观察组大于对照组,F=17.103,P<0.001;软腭长为(3.69±0.58)cm,对照组的为(4.20±0.45)cm,均较干预前缩小,且观察组小于对照组,F=18.770,P<0.001。观察组的用力肺活量(FVC)为(2.34±0.45)L,对照组的为(2.12±0.50)L,均较干预前增加,且观察组高于对照组,F=5.567,P=0.020;1秒用力呼气容积(FEV_(1))为(1.48±0.31)L,对照组的为(1.26±0.29)L,均较干预前增加,且观察组高于对照组,F=9.545,P=0.003;FEV_(1)/FVC为(72.68±6.44),对照组的为(68.53±6.70),均较干预前增加,且观察组高于对照组,F=7.963,P=0.006。结论CTAR联合强化肺康复训练可通过改善OSA-COPD患者的口咽部形态,提高肺通气功能,改善患者的睡眠情况。
Objective To investigate the effect of chin resistance training(CTAR)on pulmonary ventilation function,oropharynx morphology and polysomnography parameters in patients with obstructive sleep apnea(OSA)and chronic obstructive pulmonary disease(COPD).Methods A total of 105 patients with OSA-COPD admitted to the First Affiliated Hospital of Zhengzhou University from January 1,2019 to August 31,2020 were selected as the research objects,and divided into the control group(n=52)and the observation group according to the random number table method(n=53).The control group was given intensive pulmonary rehabilitation training,and the observation group was given CTAR on the basis of the control group.Polysomnography,oropharyngeal morphological indicators and pulmonary ventilation function were compared between the two groups.Results After 12 weeks of intervention,the apnea-hypopnea index(AHI)of the observation group was(14.08±3.72)times/h,and that of the control group was(17.26±4.25)times/h,both lower than those before the intervention,and the observation group was lower than the control group,F=6.175,P=0.015.The ratio of nighttime blood oxygen saturation<90%in the observation group to the total sleep time(TST90)was(21.33±6.11)%,and the ratio was(30.26±8.04)%in the control group,both lower than those before the intervention,and the observation group was lower than the control group,F=39.424,P<0.001.The lowest blood oxygen saturation(LowSpO_(2))at night in the observation group was(83.52±8.04)%,and(76.59±7.20)%in the control group,both higher than before intervention,and the observation group was higher than the control group,F=20.437,P<0.001.The retropalatal distance of the observation group was(0.42±0.12)cm,and that of the control group was(0.34±0.11)cm,both greater than those before intervention,and the observation group was greater than the control group,F=11.774,P=0.001.The posterior distance of the tongue was(2.08±0.26)cm in the observation group and(1.90±0.30)cm in the control group,both greater than those before the intervention,and the observation group was greater than the control group,F=17.103,P<0.001.The length of the soft palate in the observation group was(3.69±0.58)cm and that in the control group was(4.20±0.45)cm,which were both smaller than those before the intervention,and the observation group was smaller than the control group,F=18.770,P<0.001.The forced vital capacity(FVC)of the observation group was(2.34±0.45)L,and that of the control group was(2.12±0.50)L,both increased compared with those before the intervention,and the observation group was higher than the control group,F=5.567,P=0.020.The forced expiratory volume in 1second(FEV_(1)1)of the observation group was(1.48±0.31)L and that of the control group was(1.26±0.29)L,which were both higher than those before the intervention,and the observation group was higher than the control group,F=9.545,P=0.003.The FEV_(1)/FVC of the observation group was 72.68±6.44,and that of the control group was 68.53±6.70,both increased compared with those before the intervention,and the observation group was higher than the control group,F=7.963,P=0.006.Conclusion CTAR combined with intensive pulmonary rehabilitation training can improve the oropharyngeal morphology of OSA-COPD patients,improve pulmonary ventilation function,and improve the sleep condition of patients.
作者
段兰兰
钱小倩
申月月
薛婷婷
DUAN Lan-lan;QIAN Xiao-qian;SHEN Yue-yue;XUE Ting-ting(Second Department of Respiratory Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《社区医学杂志》
CAS
2022年第12期693-697,共5页
Journal Of Community Medicine
关键词
下颏抗阻力训练
阻塞性睡眠呼吸暂停
慢性阻塞性肺疾病
强化肺康复训练
chin resistance training
obstructive sleep apnea
chronic obstructive pulmonary disease
intensive lung rehabilitation training
