在严重的慢性阻塞性肺病中,负压通风的作用
S H Shapiro1, P Ernst, K Gray-Donald
1Department of Epidemiology, McGill University, Montreal, Quebec, Canada.
Lancet (London, England)
|December 12, 1992
概括
负压通风 (NPV) 并没有改善慢性阻塞性肺病 (COPD) 患者的结果. 这项研究发现,NPV对静止呼吸道肌肉无效,患者接受不佳.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 肺部康复治疗 肺部康复治疗
- 临床试验 临床试验
背景情况:
- 慢性阻塞性肺病 (COPD) 经常与呼吸肌肉疲劳有关.
- 鼓舞性肌肉休息是COPD患者的潜在治疗策略.
研究的目的:
- 测试假设休息的呼吸肌肉与负压通风 (NPV) 改善严重的COPD患者的结果.
- 评估稳定的COPD中NPV的有效性和患者接受度.
主要方法:
- 一个为期12周的,双盲,随机对照试验,涉及184名严重的COPD患者.
- 患者在家中接受了积极的或虚假的NPV治疗.
- 主要结局:6分钟的步行测试距离. 二次结果:运动耐力,呼吸不全,生活质量,血液气体,呼吸肌肉强度.
主要成果:
- 在6分钟步行测试,运动耐力,呼吸困难,生活质量,血液气体或呼吸肌肉强度之间,在活跃和假的NPV组之间没有发现显著差异.
- 在NPV使用和患者结果之间没有发现剂量反应关系.
- 尽管有临床支持,但患者对NPV干预措施的接受度很低.
结论:
- 在本研究中应用的负压通风很难实现,并且没有证明在稳定的COPD患者的静止呼吸肌肉中有效.
- 这些发现表明,NPV不是一个合适的干预措施来改善这一患者群体的结果.
- 可能需要进一步的研究来探索其他方法,以启发性肌肉休息在COPD.
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