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

摘要

Objective To observe the efficacy of early pulmonary rehabilitation training on respiratory function of patients with hypox-emia after coronary artery bypass grafting. Methods From February, 2013 to September, 2016, 53 patients with hypoxemia after coronary ar-tery bypass grafting were randomly divided into 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 expirato-ry 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 PaO2 was higher (t=5.824, P<0.001); the FEV1 (measured), FEV1(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 ven-tilation time and ICU stay between two groups (P>0.05). Conclusion Early respiratory exerciser training could improve the respiratory func-tion of patients with hypoxemia after coronary artery bypass grafting, shorten hospital stay.%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(FEV1)(实测值)和FEV1/用力肺活量(FVC)明显高于对照组(t>3.590,P<0.01),氧分压(PaO2)水平显著高于对照组(t=5.824,P<0.001);两组FEV1(实测值)、FEV1(实测值/预计值)和FEV1/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 PaO2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.