高频胸壁振荡排痰仪对单孔胸腔镜肺叶切除术后肺功能的影响  

Effect of High-frequency Chest Wall Oscillatory on Lung Function in Patient After Single Port Video-assisted Thoracoscopic Surgery Lobectomy

作　　者：朱雪娟[1] 程元骏 杨文涛[1] 陈勇兵[1] 施立[1] Xuejuan ZHU;Yuanjun CHENG;Wentao YANG;Yongbing CHEN;Li SHI(Department of Cardiothoracic Surgery,the Second Hospital Affiliated to Soochow University,Suzhou 215004,China)

机构地区：[1]苏州大学附属第二医院胸心外科,苏州215004

出　　处：《中国肺癌杂志》2018年第12期885-889,共5页Chinese Journal of Lung Cancer

摘　　要：背景与目的高频胸壁振荡排痰仪(high-frequency chest wall oscillatory, HFCWO)是一种新型的辅助排痰装置,但其相关的作用效果仍不明确。本研究通过比较高频胸壁振荡排痰仪使用前后患者排痰量的变化,进一步探讨高频胸壁振荡排痰仪对单孔胸腔镜(single port video-assisted thoracoscopic surgery lobectomy, S-VATS)肺叶切除术后肺功能和血气分析的影响。方法收集2017年1月-2017年12月于苏州大学附属第二医院行S-VATS肺叶切除术患者共90例,随机分为实验组和对照组,每组45例。实验组患者采用高频胸壁振动排痰仪排痰,对照组采用常规拍背排痰。检测两组术后前5天的排痰量以及两组术前、术后第7天肺功能和动脉血气分析。结果实验组治疗后排痰量均多于对照组,且术后第1天、第2天、第3天比较差异有统计学意义(P<0.05)。两组术前第1秒用力呼气容积(forced expiratory volume in one second, FEV1)、用力肺活量(forced vital capacity, FVC)及PaO2比较差异无统计学意义(P>0.05);术后两组FEV1、FVC及PaO2均较术前下降(P<0.05);但实验组FEV1、FVC及PaO2均高于对照组(P<0.05);两组术前、术后PaCO2比较差异无统计学意义(P>0.05)。结论 S-VATS肺叶切除术后给予高频胸壁振荡排痰仪可以显著提高排痰量,改善肺功能和缺氧状态,临床疗效满意。Background and objective It has been confirmed that high-frequency chest wall oscillatory(HFCWO) is a new type of auxiliary sputum discharge device. However, up to now, the specific therapeutic effect of HFCWO is still uncertain. This study aimed to compare the changes of the sputum volume before and after the treatment of HFCWO, and to investigate the effect of HFCWO on lung function and arterial blood gas analysis after single port video-assisted thoracoscopic surgery lobectomy(S-VATS). Methods A total of 90 patients with S-VATS lobectomy were collected in the Second Affiliated Hospital of Soochow University from January 2017 to December 2017, which were randomly divided into the experimental group with HFCWO(n=45) and the control group(n=45) with routine clapping, respectively. The sputum volume of the two groups was measured 5 days before operation. Lung function and arterial blood gas analysis was measured before and 7 th days after surgery. Results The sputum volume was higher in the experimental group than that of the control group after surgery, there was statistically significant difference for the first three days(P<0.05). There was no statistically significant difference between the two groups in forced expiratory volume in one second(FEV1), forced vital capacity(FVC) and oxygen partial pressure(PaO2) before surgery(P>0.05); Compared with those before surgery, FEV1, FVC and PaO2 decreased in both groups after surgery(P<0.05); However, FEV1, FVC and PaO2 in the experimental group were higher than those in the control group(P<0.05); There was no statistically significant difference in preoperative and postoperative partial pressure of carbon dioxide(Pa CO2) between the two groups(P>0.05). Conclusion HFCWO can significantly increase the amount of sputum excretion, improve lung function and alleviate hypoxia status after S-VATS lobectomy. This study provides a promising approach for HFCWO toward hypoxia status after S-VATS lobectomy.

关 键 词：单孔 胸腔镜 高频胸壁振荡排痰仪 肺功能 

分 类 号：R734.2[医药卫生—肿瘤]