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

作　　者：兰蕴平[1] 吴娅秋[1] 黎嘉嘉[1] 刘蓉安[1] 罗小秀[1] 黄晓波[1] 

机构地区：[1]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

出　　处：《中国康复理论与实践》2017年第6期709-713,共5页Chinese Journal of Rehabilitation Theory and Practice

基　　金：四川省医学会医学科研课题计划项目(No.S16072)

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(FEV_1)(实测值)和FEV_1/用力肺活量(FVC)明显高于对照组(t>3.590,P<0.01),氧分压(PaO_2)水平显著高于对照组(t=5.824,P<0.001);两组FEV_1(实测值)、FEV_1(实测值/预计值)和FEV_1/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 PaO_2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。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 imo 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 PaO： was higher （t=5.824, P〈0.001）; the FEV1 （measured）, FEV,（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 high- est 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.

关 键 词：冠脉搭桥手术 低氧血症 呼吸训练器 肺康复 

分 类 号：R654.2[医药卫生—外科学]