渐进式呼吸功能训练方法对脊柱侧凸患者术前肺功能的影响

摘要

目的 通过对脊柱侧凸矫形术患者术前呼吸功能渐进式训练方法,提高患者术前的肺功能指标,增强脊柱侧凸患者术前耐受手术的能力,减少手术中意外风险的发生.方法 选择2011年7月至2012年7月收治的70例脊柱侧凸患者,术前进行呼吸功能渐进式训练,训练周期为7 ～10d,由1名专职护士负责指导、评估和记录,训练前后进行肺功能指标检测,包括肺活量、最大通气量及分别占预计值的百分比.结果 脊柱侧凸患者呼吸训练后平均最大吸气值、训练频率分别为(1 877.22±672.21) ml,(320.60±123.40)次/d,均高于训练前的(1 466.12±720.10)ml,(102.40±48.20)次/d,差异均有统计学意义(t分别为4.02,6.88;P ＜0.01)；训练前后患者脉搏频率、血氧饱和度比较,差异均无统计学意义(P＞0.05).训练后患者肺活量、肺活量占预计值的百分比、最大通气量、最大通气量占预计值的百分比分别为(2.48±0.70)L,(70.40±12.34)％,(58.21±10.01)L,(90.44±15.40)％,均高于训练前的(1.80±0.65)L,(62.34±10.17)％,(47.02±11.32)L,(83.80±13.20)％,差异均有统计学意义(t分别为3.51,2.88,4.15,3.33;P ＜0.01).结论 对脊柱侧凸患者术前进行渐进式呼吸功能训练,有效提高了患者术前呼吸功能的效果,最大限度地提高了深吸气值,增强了肺功能,对脊柱侧凸患者适应手术要求并减少手术中危险因素,及术后进一步实施呼吸功能训练提供了技术支持,值得临床推广应用.%Objective To improve indexes of pre-operative pulmonary function and operative tolerance,as well as to avoid accidental risks during operation by using gradual training methods of breathing function for patients with scoliosis.Methods Totals of 70 patients with scoliosis from July 2011 to July 2012 were chosen and trained with gradual methods of breathing function for 7 to 10 days.One nurse was in charge of guidance,evaluation and recording.Indexes of pulmonary function,including breathing capacity,maximal ventilatory capacity and percentages among predicted value,were compared before and after training.Results Average maximal ventilatory capacity and training frequency were respectively (1 877.22 ± 672.21)ml and (320.60 ±123.40) times/d after training,both higher than (1 466.12 ± 720.10) ml and (102.40 ± 48.20) times/d before training,and the differences were statistically significant (t =4.02,6.88,respectively; P ＜ 0.01).There was no statistically significant difference of pulses and degree of blood oxygen saturation before and after training.Breathing capacity and its percentage among predicted value,maximal ventilatory capacity and its percentage among predicted value were respectively (2.48 ± 0.70) L,(70.40 ± 12.34) ％,(58.21 ± 10.01) L and (90.44 ± 15.40) ％ after training,all of which were higher than (1.80 ± 0.65) L,(62.34 ± 10.17) ％,(47.02 ± 11.32)L and (83.80 ± 13.20)％ before training,and the differences were statistically significant (t =3.51,2.88,4.15,3.33,respectively; P ＜ 0.01).Conclusions Gradual training methods of breathing function on patients with scoliosis can improve their pre-operative pulmonary function,which provides technical support for patients' adoption to operations,reduction of risks and further training of breathing function,thus worthy of promotion.