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.
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
.
DOI: 10.3969/j.issn.1006-9771.2017.06.019
[1] 孙勇,池一凡,侯文明. 冠心病围手术期低氧血症相关因素分析[J]. 中外医疗, 2009, 8(29): 11-12.
[2] Oldridge NB, Guyatt GH, Fischer ME, et al. Cardiac rehabilitation after myocardial infarction combined experience of randomized clinical trials [J]. JAMA, 1988, 260(7): 945-950.
[3] O'Connor CM, Whellan DJ, Lee KL, et al. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial [J]. JAMA, 2009, 301: 1439-1450.
[4] Ornish D, Scherwitz LW, Billings JH, et al. Intensive lifestyle changes for reversal of coronary heart disease [J]. JAMA, 1998, 280(23): 2001-2007.
[5] Atabaki A, Fine J, Haggerty M, et al. Effectiveness of repeated courses of pulmonary rehabilitation on functional exercise capacity in patients with COPD [J]. J Cardiopulm Rehabil Prev, 2015, 35(4): 272-277.
[6] Atsou K, Crequit P, Chouaid C, et al. Simulation-based estimates of the effectiveness and cost-effectiveness of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease in France [J]. PLoS One, 2016, 11(6): e0156514.
[7] 孙雨明,李平. 冠脉搭桥术后康复医疗[J]. 中国心血管康复医学, 1995, 4(3): 75-79.
[8] Ji Q, Mei Y, Wang X, et al. Study on the risk factors of postoperative hypoxemia in patients undergoing coronary artery bypass grafting [J]. Circ J, 2008, 72(12): 1975-1980.
[9] Barr J, Fraser GL, Puntillo K, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit [J]. Crit Care Med, 2013, 41(1): 263-306.
[10] Ranucci M, Ballotta A, La Rovere MT, et al. Postoperative hypoxia and length of intensive care unit stay after cardiac surgery: the underweight paradox? [J]. PLoS One, 2014, 9(4): e93992.
[11] Santos NP, Mitsunaga RM, Borges DL, et al. Factors associated to hypoxemia in patients undergoing coronary artery bypass grafting [J]. Rev Bras Cir Cardiovasc, 2013, 28(3): 364-370.
[12] 张家俊,胡盛寿. 70岁以上高龄患者冠状动脉旁路移植术围术期处理经验[J]. 中国胸心血管外科临床杂志, 2003, 10(3): 207-209．
[13] Asimakopoulos G, Smith PL, Ratnatunga CP, et al. Lung injury and acute respiratory distress syndrome after cardiopulmonary bypass [J]. Ann Thorac Surg, 1999, 68(3): 1107-1115.
[14] Andrejaitiene J, Sirvinskas E, Bolys R. The influence of cardiopulmonary bypass on respiratory dysfunction in early postoperative period [J]. Medicina (Kaunas), 2004, 40(Suppl 1):7-12.
[15] Krdzalic A, Klokocovnik T, Krdzalic G, et al. The influence of cardiopulmonary by-pass on respiratory function in patients who underwent coronary disease surgery [J]. Med Arch, 2013, 67(2): 97-100.
[16] Campo G, Pavasini R, Malagu M, et al. Chronic obstructive pulmonary disease and ischemic heart disease comorbidity: overview of mechanisms and clinical management [J]. Cardiovasc Drugs Ther, 2015, 29(2): 147-157.
[17] Scott BH, Seifert FC, Grimson R, et al. Octogenarians undergoing coronary artery bypass graft surgery: resource utilization, postoperative mortality, and morbidity [J]. J Cardiothorac Vasc Anesth, 2005, 19(5): 583-588.
[18] Warner DO. Preventing postoperative pulmonary complications: the role of the anaesthesiologist [J]. Anesthesiology, 2000, 92: 1467-1472.
[19] Rochester CL, Ioannis V, Holland AE, et al. An official American Thoracic Society/European Respiratory Society Policy Statement: enhancing implementation, use, and delivery of pulmonary rehabilitation [J]. Am J Respir Crit Care Med, 2015, 192(11): 1373-1386.
[20] Elci A, Ovayolun N, Elbek O. The efficacy and applicability of a pulmonary rehabilitation programme for patients with COPD in a secondary-care community hospital [J]. Respiratory, 2008, 13(5): 703-707.
[21] Casaburi R, ZuWallack R. Pulmonary rehabilitation for management of chronic obstructive pulmonary disease [J]. N Engl J Med, 2009, 360(13): 1329-1335.
[22] Savci S, Degirmenci B, Saglam M, et al. Short-term effects of inspiratory muscle training in coronary artery bypass graft surgery: a randomized controlled trial [J]. Scand Cardiovasc J, 2011, 45(5): 286-293.
[23] Ries AL, Bauldoff GS, Carlin BW, et al. Pulmonary rehabilitation: joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines [J]. Chest, 2007, 131(5 Suppl): 4S-42S.
[24] Heerema-Poelman A, Stuive I, Wempe JB. Adherence to a maintenance exercise program 1 year after pulmonary rehabilitation: what are the predictors of dropout? [J]. J Cardiopulm Rehabil Prev, 2013, 33(6): 419-426.
[25] 邵剑,张馨. 术前呼吸功能锻炼对胸心外科手术病人肺功能的影响[J]. 中华护理杂志, 2004, 39(6): 401-402.
