呼吸功能训练联合益肠汤治疗对老年腹腔镜胆囊切除术患者术后肺功能的影响

Efficacy of postoperative respiratory function training and beneficial intestinal soup on pulmonary function of laparoscopic cholecystectomy patients

目的评价呼吸功能训练联合益肠汤治疗对老年腹腔镜胆囊切除术患者术后肺功能的影响。方法收集2015年1月至2015年10月本院108例行腹腔镜胆囊切除术的老年患者的临床资料,根据干预方法不同将其分为对照组和观察组,每组各54例。对照组患者术后给予常规禁食、补液、胃肠减压、抗感染等对症支持治疗,观察组患者在对照组常规治疗基础上采取呼吸功能训练与益肠汤胃管灌注治疗。对比两组患者术后血气分析、肺功能、胃肠功能恢复情况等指标。结果两组患者术后动脉血p H比较无显著差异(P>0.05),观察组患者动脉血氧分压明显高于对照组,动脉血二氧化碳分压明显低于对照组(P<0.05);观察组患者肺活量、用力肺活量(FVC)、第一秒用力呼气量占用力肺活量百分率均高于对照组(P<0.05),且术后肠鸣音恢复时间、肛门排气时间、肛门排便时间、进食时间均短于对照组(P<0.05)。结论腹腔镜胆囊切除术后行呼吸功能训练联合益肠汤治疗,对改善患者肺功能及胃肠功能具有积极影响。

Objective To evaluate the efficacy of postoperative respiratory function training and beneficial intestinal soup on pulmonary function of laparoscopic cholecystectomy patients. Method The clinical data of 108 elderly patients underwent laparoscopic cholecystectomy in our hospital from January 2015 to October 2015 were divided into observation group and control group（54 cases in each） according to the different intervention methods. Control group patients received symptomatic supportive treatment（postoperative fasting, rehydration, gastrointestinal decompression, anti-infection）. Except for above mentioned treatments, observation group patients received respiratory function training and beneficial intestinal soup stomach tube perfusion treatment as well. Observed and compared the blood gas analysis indexes, pulmonary function indexes, gastrointestinal functional recovery indexes of the two groups after intervention. Result The difference of p H was not statistically significant between the two groups（P〉0.05）. Observation group of patients with arterial blood oxygen partial pressure（Pa O_2） was higher than control group, arterial blood CO2 partial pressure（Pa CO2） was lower than control group, the comparative differences were statistically significant（P〈0.05）; vital capacity（VC）, forced vital capacity（FVC）, percentage of forced expiratory volume in first second to forced vital capacity（FEV1%） of observation group were significantly higher than control group（P〈0.05）. The postoperative bowel sound recovery time, anus exhaust time, anus bowel movement time and first eating time of observation group were also significantly less than control group（P〈0.05）. Conclusion Respiratory function training joint beneficial intestinal soup has positive effect on improving pulmonary function and gastrointestinal function of laparoscopic cholecystectomy patients.