术前呼吸功能锻炼对肥胖患者腹腔镜手术肺功能的影响  

The influence of preoperative respiratory function exercises on pulmonary function in obese patients following laparoscopic surgery

作　　者：侯念果[1] 戴晓凤[2] 滕娜[1] 杨洪光[1] 梁忆波[3] 李会[1] HOU Nian-guo;DAI Xiao-feng;TENG Na;YANG Hong-guang;LIANG Yi-bo;LI Hui(Department of Anesthesiology,Qingdao Municipal Hospital,Qingdao,Shandong,266011;Departmentof Anesthesiology,The Second Affiliated Hospital of Qingdao University,Qingdao Shandong,266011;Department of General Surgery,Qingdao Municipal Hospital,Qingdao,Shandong,266011)

机构地区：[1]青岛市市立医院麻醉科,山东青岛266011 [2]青岛大学医学院第二附属医院麻醉科,山东青岛266011 [3]青岛市市立医院普外科,山东青岛266011

出　　处：《临床普外科电子杂志》2019年第3期8-11,共4页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的探讨术前呼吸功能锻炼对肥胖患者腹腔镜手术肺功能的影响。方法选取行腹腔镜直肠癌根治术的手术患者60例,ASA分级Ⅰ-Ⅱ级,BMI30~40kg/m^2,随机分为实验组和对照组,实验组术前1周开始采用缩唇呼吸、腹式呼吸和用力呼气技术训练进行呼吸功能锻炼,3次/d,每次15~30min,呼吸功能锻炼前(T1)、呼吸功能锻炼后麻醉插管前(T2)、麻醉拔管后1d(T3)、3d(T4)的动脉血氧分压(PaO2)、肺泡一动脉氧分压差(PA-aD02)以及FVC、FEV1.0。结果与对照组相比较,实验组FVC、FEVl.0及PaO2以上各组数据均增高,A-aD02数值减低,差异具有统计学意义(P<0.05)。结论术前呼吸功能锻炼对肥胖患者腹腔镜手术术后肺功能有明显提升作用,应当提倡对肥胖患者进行术前呼吸功能锻炼。Objective To investigate the infl uence of preoperative respiratory function exercises on pulmonary function in obese patients following laparoscopic surgery.Methods Sixty patients accepting laparoscopic radical resection of rectal cancer,ASA I-II,BMI 30-40kg /m2,were randomly divided into two groups.The experimental group of patients exercised using the shrink lip breathing 、abdominal breathing and forced breath training for 3 times a day and 15-30mins each time.Three time points were selected that are prior to exercise (T1),prior to intubation (T2) and extubation 1 day later (T3) and 3 day later (T4).Arterial oxygen (PaO2),alveolar arterial oxygen partial the pressure difference (A-aD02), forced vital capacity (FVC) and forced expiratory volume in one second (FEV1.0) were measured. Results Compared with the control group,all data of FVC、FEVl.0 and Pa02 from the experimental group increased,data of A-aD02 from the experimental group reduced.The difference was statistically significant.Conclusion Preoperative respiratory function exercise for laparoscopic surgery on obese patients enhance lung function and should be promoted.

关 键 词：呼吸功能 锻炼 肥胖 肺功能 腹腔镜 

分 类 号：R473.6[医药卫生—护理学]