老年开胸术后胸部物理治疗对血气及血液循环的影响

The effect of early chest physiotherapy on blood gas and circulatory function in old patients after Thoracotomy

为了探讨老年患者开胸术后早期行有效的胸部物理治疗对血气的改善及循环功能的影响，经１５例自身对照研究发现，开胸术后６ｈ开始头高位，雾化吸入后翻身拍背能使ＰａＯ＿２、ＳａＯ＿２显著升高，ＰａＣＯ＿２下降。治疗期间血压保持相对稳定，但有３例出现心律失常（均为术前心电图异常者）。此结果提示：早期开始有效的胸部物理治疗能明显改善老年开胸术后低氧血症。但术前心电图异常者存在心律失常之虑，应严密监护。

In this study, 15 old patients undergoing thoracotomy were selected for observing the influence of effective chest physiotherapy started early in postoperation on blood gas and circulatory function. Following ultrasonic aerosol inholation for 20 minutes, turning the body, and chest percussion in head-up were started at 6th hour after operation. The result showed that PaO_2 ,SaO_2 were significantly increased and PaCO_2 were decreased at 30 minutes after treatment comparied with it before treatment. In other side, although the hemodynamics could maintain stabilization,cardiac arrhythmias were occured during treatment in three cases,whose ECG were abnormal in preopration. It concluded that effectively chest physiotherapy, started early in postoperation, could prevent postoperative hypoxemia in old thoracotomy patients,But,ECG monitoring is necessary during treatment in patients whose ECG was abnormal before operation.