| ObjectiveChronic obstructive pulmonary disease(COPD)is a chronic airway inflammatory disease.Besides drug treatment,pulmonary rehabilitation training has received increasing attention.Etermal diaphragm pacing(EDP)is one of the easiest and non-invasive ways in pulmonary rehabilitation training.In this study,external diaphragm pacemaker is used on patients with acute exacerbation of COPD(AECOPD).The physical activities in daily life,dyspnea,pulmonary function,diaphragm thickness and diaphragmatic mobility are observed before and after treatment to evaluate the effect of external diaphragm pacemaker on ventilation function of AECOPD patients.MethodsWe reviewed medical records of 120 AECOPD patients(GOLD class ?-?,control group n=60,treatment group n=60)in Wuxi No.5 Peopled Hospital from October 2017 to June 2018.All patients met the definition of acute exacerbation in the Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease(GOLD,updated 2016).Both groups were treated with conventional therapy.After 7days,the effects on patients with EDP were evaluated,including 6-minute walking test(6MWT),Borg score,COPD assessment test(CAT),modified British medical research council(mMRC score),pulmonary function(FEV1,FEV1/FVC,FEV1%Pred,VC,MVV),arterial blood gas(PH,SpO2,PaO2 and PaCO2),diaphragmatic thickness and diaphragmatic mobility.In this study,SPSS22.0 software was adopted for statistical analysis,while all measurement data were expressed to evaluate the treatment effect,and P<0.05 was considered statistically significant.ResultsBefore treatment,the 6-minute walking distance(6MWD)of the experimental group and control group were(409.00±51.29)m and(409.70±44.90)m,respectively.After treatment,the 6MWD of the experimental group and control group were(485.55±51.75)m and(461.09±46.73)m,respectively.Inter-group comparison showed that before treatment,the difference between the experimental group and control group was not statistically significant(t=0.081,P=0.935).After treatment,the 6MWD of the experimental group was greater than that of the control group,and the difference was statistically significant(t?2.716,P=0.008).Intra?group comparison showed that the 6MWD of the experimental group and control group increased(76.52±43.57)m and(51.33±58.47)m,respectively.The difference was statistically significant(P<0.001).Before treatment,the CAT seores of the experimental group and eontrol group were(29.67±3.27)and(29.73±2.71),respectively.The mMRC scores were(2.70±0.72)and(2.67±0.60),respectively.The Borg scores were(4.40±0.91)and(4.38±0.83),respectively.After treatment,the CAT scores of the experimental group and control group were(21.62±3.94)and(24.00±3.65),respectively.The mMRC scores were(2.10±0.73)and(2.37±0.61),respectively.The Borg scores were(3.57±1.02)and(4.03±1.09),respectively.Inter-group comparison showed that before treatment,there were no statistically significant differences in CAT,mMRC and Borg scores between the two groups(P>0.05).After treatment,CAT score of the experimental group was lower than that of the control group,and the difference was statistically significant(t?3.437,P=0.001),mMRC score of the experimental group was lower than that of the control group,and the difference was statistically significant(t?2.173,P=0.032),and Borg score of the experimental group was lower than that of the control group(t?2.429,P=0.017).Intra-group comparison showed that,the CAT score,mMRC score and Borg score of the experimental group decreased(8.05±1.93),(0.60±0.49)and(0.83±0.46),respectively,and the corresponding scores of the control group decreased(5.73±2.02),(0.30±0.50)and(0.35±0.48),respectively.Both groups had decreased after treatment compared with before treatment,both of which were statistically significant(P<0.05).Before treatment,the FEV1(L)of the experimental group and control group were(1.26±0.44)and(1.23±0.40),respectively.The FEV1/FVC(%)were(45.21±0.39)and(44.23±10.04),respectively.The FEV1%Pred were(55.18±9.46)and(55.17±8.28),respectively.The VC(L)were(3.03±0.51)and(3.04±0.49),respectively.The MVV(L/min)were(49.74±3.67)and(49.79±3.34),respectively.After treatment,the FEV1(L)of the experimental group and control group were(1.95±0.46)and(1.26±0.43),respectively.The FEV1/FVC were(66.61±9.58)and(45.20±11.43),respectively.The FEV1%Pred were(85.34±9.29)and(56.08±10.34),respectively.The VC(L)were(3.34±0.50)and(3.08±0.46),respectively.The MVV(L/min)were(69.24±4.12)and(50.34±4.01),respectively.Inter-group comparison showed that before treatment,there vere no statistically significant differences in FEV1,FEV1/FVC,FEV1%Pred,VC and MVV(P>0.05),and after treatment,the above indicators were higher in the experimental group than in the control group with statistically significant differences(P<0.05).Intra-group comparison showed that after treament,the FEV1,FEV1/FVC,FEV1%Pred,VC and MVV of the experiment group increased(0.69±0.24),(21.35±9.42)%,(30.13±3.95)%,(0.31±0.17)and(19.50±3.41),respectively.The increasements all were statistically significant(P<0.05).While in the control group,the FEV1,FEV1/FVC,FEV1%Pred,VC and MVV increased(0.03±0.13),(0.74±4.83),(0.81±3.37),(0.04±0.17)and(0.55±2.45),respectively after treatment.There was no statistically significant difference between the above indicators after treatment and those before treatment(P>0.05).Before treatment,the PaO2 values(mmHg)of the experimental group and control group were(61.72±7.17)and(61.58±7.11),respectively.The PaCO2 values(mmHg)were(54.95±3.16)and(69.45±6.32),respectively.The oxygen saturation(SpO2)values were(93.00±0.80)and(92.92±1.12),respectively.The PH values were(7.37±0.02)and(7.38±0.01),respectively.After treatment,the PaO2 values(mmHg)of the experimental group and control group were(74.05±7.22)and(69.45±6.32),respectively.The PaCO2 values(mmHg)were(45.53±2.55)and(49.38±2.64),respectively.The SpO2 values were(94.93±0.90)and(93.92±0.96),respectively.The PH values were(7.43±0.02)and(7.40±0.01),respectively.Inter-group comparison showed that before treatment,the differences in PaO2,PaCO2,SpO2 and PH between the two groups were not statistically significant(P>0.05).After treatment,PaO2,SpO2 and PH in the experimental group were all higher than those in the control group,and the differences were statistically significant(P<0.05).PaCO2 in the experimental group was lower than that in the control group,and the difference was statistically significant(t?7.032,P<0.001).Intra-group comparison showed that in the experimental group and the control group,PaO2 increased(10.60±3.89)and(6.28±2.46),respectively,SpO2 increased(5.73±2.89)and(3.38±2.92),respectively,PaCO2 decreased(1.93±1.07)and(1.00±1.75),respectively,and PH increased(0.06±0.02)and(0.02±0.01),respectively.The changes of the above indicators in both groups were statistically significant(P<0.05).Before treatment,the diaphragm thickness values(cm)of the experimental group and control group were(0.171±0.034)and(0.165±0.040),respectively.The diaphragm mobility values(cm)were(1.223±0.307)and(1.229±0.287),respectively.After treatment,the diaphragm thickness values(cm)of the experimental group and control group were(0.173±0.035)and(0.166±0.041),respectively.The diaphragm mobility values(cm)were(1.251±0.242)and(1.240±0.293),respectively.Inter-group comparison showed that before treatment,there was no statistically significant difference in diaphragm thickness and diaphragm mobility between the experimental group and the control group(P>0.05).After treatment,the diaphragm thickness and diaphragm mobility of the experimental group were higher than those of the control group,but there was no statistically significant differences(P>0.05).Intra-group comparison showed that in the experimental group,the diaphragm thickness increased(0.002±0.009)cm,and the diaphragm mobility increased(0.03±0.012)cm after treatment.There were no statistically significant(P>0.05)in both increasements.In the control group,the diaphragm thickness increased(0.002±0.009)cm,and the diaphragm mobility increased(0.01 ±0.04)cm after treatment.There was no statistically significant difference in the thickness and mobility of diaphragm after treatment in the control group compared with before treatment(P>0.05).ConclusionExternal diaphragn pacing for 7 days can improve the daily living ability and plumonary ventilation fuction of AECOPD patients,but can not increase the diaphragm thickness or diaphragmatic mobility of AECOPD patients. |
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