术前吸气肌训练预防成人心脏手术患者术后肺部并发症的最新进展  

Research progress on preoperative inspiratory muscle training for prevention of postoperative pulmonary complications in adult cardiac surgery

作　　者：罗泽汝心 王渝强 周亚馨 郭应强[2] 喻鹏铭[1,3] LUO Zeruxin;WANG Yuqiang;ZHOU Yaxin;GUO Yingqiang;YU Pengming(Rehabilitation Medicine Center,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Cardiovascular Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Key Laboratory of Rehabilitation Medicine of Sichuan Province,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院康复医学中心,成都610041 [2]四川大学华西医院心脏大血管外科,成都610041 [3]四川省康复医学重点实验室,成都610041

出　　处：《中国胸心血管外科临床杂志》2023年第10期1519-1523,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家重点研发计划(2018YFC2002304)。

摘　　要：过去20年,成人心脏手术无论在麻醉还是手术方式上都得到了飞跃发展,但术后肺部并发症的发生率并没有改变。在临床上术后肺部并发症仍是心脏手术后患者最常见的并发症,其导致患者预后不良、住院时间延长和医疗费用显著增加。随着加速康复外科理念的推广和普及,预康复已经成为预防术后并发症发生的基础治疗,其中术前吸气肌训练正作为一种极具潜力的干预方法被广泛而深入地研究。但由于术后肺部并发症的定义和诊断标准在全球未得到统一认识,且术前吸气肌训练在预防成人心脏手术术后肺部并发症中存在显著的异质性从而阻碍了其在临床的应用。本文通过回顾现有研究报道,针对术后肺部并发症的定义、机制和评价工具,以及术前吸气肌训练在预防心脏手术患者术后肺部并发症中的作用、实施方案和面临的挑战进行综述,以期为临床工作提供参考。In the past two decades,adult cardiac surgery has developed by leaps and bounds in both anesthetic techniques and surgical methods,whereas the incidence of postoperative pulmonary complications(PPCs)has not changed.Until now PPCs are still the most common complications after cardiac surgery,resulting in poor prognosis,significantly prolonged hospital stays and increased medical costs.With the promotion of the concept of enhanced recovery after surgery(ERAS),pre-rehabilitation has been becoming a basic therapy to prevent postoperative complications.Among them,preoperative inspiratory muscle training as a very potential intervention method has been widely and deeply studied.However,there is still no consensus about the definition and diagnostic criteria of PPCs around the world;and there is significant heterogeneity in preoperative inspiratory muscle training in the prevention of pulmonary complications after cardiac surgery in adults,which impedes its clinical application.This paper reviewed the definition,mechanism,and evaluation tools of PPCs,as well as the role,implementation plan and challenges of preoperative inspiratory muscle training in the prevention of PPCs in patients undergoing cardiac surgery,to provide reference for clinical application.

关 键 词：心脏手术 术后肺部并发症 吸气肌训练 预康复 加速康复外科 综述 

分 类 号：R654.2[医药卫生—外科学]