肺减容术前实施呼吸康复训练的临床应用  

Pre-operative Respiratory Rehabilitation Program Relieves Dyispnea and Partially Improves Lung Function of LVRS Candidates

作　　者：应美芳[1] 叶秀妹[1] 王兴安[1] 

机构地区：[1]上海市肺科医院,上海200433

出　　处：《上海护理》2004年第2期7-9,共3页Shanghai Nursing

摘　　要：目的　探讨肺减容术 (Lungvolumereductionsurgery,LVRS)前呼吸康复训练的效果。方法　对50例符合LVRS的慢性阻塞性肺疾病(COPD)患者进行为期 3个月的呼吸康复训练 ,包括缩唇腹式呼吸锻炼和使用呼吸容量锻炼器吸气锻炼 ,以及卫生宣教和心理辅导。调查训练前后患者的主观感受 ,测试 6min行走距离 (6 MWD)、1秒种内用力呼气量、(FEV1 )、氧分压 (PaO2 )、二氧化碳分压(PaCO2 )和最大自主通气量 (MVV)。结果　 50例患者中 41例完成训练计划 ,在问卷调查中 40例反映气急症状缓解占 97 6%。使用呼吸容量锻炼器的吸气量、6 MWD和MVV在训练前后有显著变化 ,但是FEV1 、PaO2 和PaCO2 变化差异无显著性。结论　缩唇腹式呼吸锻炼和使用呼吸容量锻炼器吸气锻炼能有效缓解患者主观症状 。Objective To evaluate pre-operative respiratory rehabilitation program for LVRS candidates. Methods A group of candidates for lung volume reduction surgery (LVRS) were enrolled into our 3-month respiratory rehabilitation program, including pursed-lip diaphragmatic breathing exercise, deep breathing exercise by using volumetric Exerciser, psychological rehabilita tion and hygienic instruction. Individual subjective syndromes were surveyed and lung function values (6-MWD, FEV 1, PaO 2 and MVV) were tested before and af ter training. Results Fourty one patients finished the program, among them 40 acquired certain degree of dyispnea relief, according to the ques tionnair es before and after rehabilitation program. There were statistical improvements on 6-min-walking-distance (6-MWD), MVV and the inhaled volume by using the v olumetric exerciser, but not on FEV 1, PaO 2 and PaCO 2 after 3-month training. Conclusion Pre-operative respiratory rehabilitaion, including mainly pursed-lip diaphragmatic breathing exercise, deep breathing exercise by usin g volumetric exerciser, can improve some objective syndromes and a part of lung fu nction values of LVRS candidates.

关 键 词：肺减容术 呼吸康复训练 术前 调查 慢性阻塞性肺疾病 

分 类 号：R49[医药卫生—康复医学]