早期呼吸训练器治疗对冠脉搭桥术后低氧血症患者肺部并发症的影响

doi:10.3969/j.issn.1006-9771.2017.06.019

《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (6): 709-713.doi: 10.3969/j.issn.1006-9771.2017.06.019

早期呼吸训练器治疗对冠脉搭桥术后低氧血症患者肺部并发症的影响

兰蕴平, 吴娅秋, 黎嘉嘉, 刘蓉安, 罗小秀, 黄晓波

四川省医学科学院,四川省人民医院重症医学中心外科重症监护病房,四川成都市 610072。

收稿日期:2017-01-04 修回日期:2017-03-07 出版日期:2017-06-25 发布日期:2017-06-27
通讯作者: 黄晓波。E-mail: 25412045@qq.com。
作者简介:兰蕴平(1983-),女,汉族,四川资阳市人,硕士研究生,主要研究方向：急危重症患者器官功能支持。
基金资助:
四川省医学会医学科研课题计划项目(No. S16072)

Effect of Early Respiratory Exerciser Training on Respiratory Function of Patients with Hypoxemia after Coronary Artery Bypass Grafting

LAN Yun-ping, WU Ya-qiu, LI Jia-jia, LIU Rong-an, LUO Xiao-xiu, HUANG Xiao-bo

Department of SICU, Critical Care Medicine Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, China

Received:2017-01-04 Revised:2017-03-07 Published:2017-06-25 Online:2017-06-27
Contact: Correspondence to HUANG Xiao-bo. E-mail: 25412045@qq.com

摘要/Abstract

摘要： 目的观察冠脉搭桥术后低氧血症患者早期呼吸训练器治疗的疗效。方法 2013年2月至2016年9月,冠脉搭桥术后低氧血症患者53例,随机分为对照组(n=25)和观察组(n=28)。两组均进行常规治疗,观察组在此基础上应用呼吸功能训练器进行呼吸功能锻炼。结果拔管后3 d,观察组1秒用力呼气容积(FEV₁)(实测值)和FEV₁/用力肺活量(FVC)明显高于对照组(t>3.590, P<0.01),氧分压(PaO₂)水平显著高于对照组(t=5.824, P<0.001);两组FEV₁(实测值)、FEV₁(实测值/预计值)和FEV₁/FVC均较术前降低(F>1.044, P<0.05)。观察组总住院时间短于对照组(t=-2.138, P=0.037)。两组术后1 d PaO₂水平均较术前及拔管后3 d高(P<0.001)。两组机械通气时间和ICU住院时间无显著性差异(P>0.05)。结论早期呼吸训练器肺康复治疗有助于改善冠脉搭桥术后患者肺功能,进而改善氧合状态,缩短住院时间。

关键词: 冠脉搭桥手术, 低氧血症, 呼吸训练器, 肺康复

Abstract: Objective To observe the efficacy of early pulmonary rehabilitation training on respiratory function of patients with hypoxemia after coronary artery bypass grafting. Methods From February, 2013 to September, 2016, 53 patients with hypoxemia after coronary artery bypass grafting were randomly divided into control group (n=25) and observation group (n=28). Both of them received routine therapy, while the observation group received pulmonary rehabilitation training in addition. Results Three days after extubation, the forced expiratory volume in one second (FEV₁) (measured) and FEV₁/ forced vital capacity (FVC) were higher in the observation group than in the control group (t>3.590, P<0.01), while the level of PaO₂ was higher (t=5.824, P<0.001); the FEV₁ (measured), FEV₁(measured/ predicted) and FEV₁/FVC decreased in both groups (F>1.044, P<0.05). The hospital stay was shorter (t=-2.138, P=0.037). The level of PaO₂ was the highest one day after extubation among three time points in both groups (P<0.001). No significantly difference was observed in mechanical ventilation time and ICU stay between two groups (P>0.05). Conclusion Early respiratory exerciser training could improve the respiratory function of patients with hypoxemia after coronary artery bypass grafting, shorten hospital stay.

Key words: coronary artery bypass graft, hypoxemia, respiratory exerciser, pulmonary rehabilitation

中图分类号:

R654.2

兰蕴平, 吴娅秋, 黎嘉嘉, 刘蓉安, 罗小秀, 黄晓波. 早期呼吸训练器治疗对冠脉搭桥术后低氧血症患者肺部并发症的影响[J]. 《中国康复理论与实践》, 2017, 23(6): 709-713.

LAN Yun-ping, WU Ya-qiu, LI Jia-jia, LIU Rong-an, LUO Xiao-xiu, HUANG Xiao-bo. Effect of Early Respiratory Exerciser Training on Respiratory Function of Patients with Hypoxemia after Coronary Artery Bypass Grafting[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(6): 709-713.

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早期呼吸训练器治疗对冠脉搭桥术后低氧血症患者肺部并发症的影响

Effect of Early Respiratory Exerciser Training on Respiratory Function of Patients with Hypoxemia after Coronary Artery Bypass Grafting

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