早期呼吸功能锻练联合经鼻高流量氧疗对法洛四联症手术患儿康复及肺功能的影响

Early Respiratory Function Exercise Combined with Nasal High Flow Oxygen Therapy on Rehabilitation and Pulmonary Function in Children with Tetralogy of Fallot

[目的]探讨早期呼吸功能锻练联合经鼻高流量氧疗对法洛四联症(TOF)手术治疗的患儿康复及肺功能的影响.[方法]选择2016年3月至2018年3月本院收治的87例T OF患儿,按照随机数字表法随机分为观察组( n =44)和对照组( n =43).观察组采用早期呼吸功能锻练联合经鼻高流量氧疗,对照组采用经鼻高流量氧疗.两组治疗均持续1个月,比较两组患儿生活质量评分(SGRQ )、治疗前后血气分析指标及肺功能的变化情况.[结果]治疗后,两组患儿 SGRQ 评分降低,且观察组 SGRQ 评分低于对照组( P <0 .05).治疗后两组动脉氧分压(PaO2 )、pH值、脉搏血氧饱和度(SpO2 )值升高,动脉二氧化碳分压(PaCO2 )值下降,观察组PaO2 、pH值、SpO2 值高于对照组,PaCO2 水平低于对照组( P <0 .05).治疗后,两组患者肺功能指标肺活量占预计值百分比(VC)、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气容积/用力肺活量(FEV1/FVC )均升高,且观察组 VC 、FEV1 、FVC 、FEV1/FVC 值高于对照组( P < 0 .05 ).[结论]早期呼吸功能锻练联合经鼻高流量氧疗治疗TOF能有效提高术后患儿生活质量,缩短住院时间,改善患儿血气指标及肺功能,且安全性高.

[Objective]To explore the effect of early respiratory function training combined with nasal high flow oxygen therapy on the rehabilitation and pulmonary function of children with tetralogy of Fallot (T OF).[M ethods]Eighty‐seven children with T OF admitted to our hospital from M arch 2016 to M arch 2018 were randomly divided into observation group ( n =44) and control group ( n =43) according to random number table method .T he observation group was treated with early respiratory function exercise combined with nasal high flow oxygen therapy ,w hile the control group was treated with nasal high flow oxygen therapy .T he two groups were treated for one month .T he changes of SGRQ ,blood gas analysis index and pulmonary function before and after treatment were compared between the two groups .[Results]After treatment ,the SGRQ score of the two groups decreased ,and the SGRQ score of the observation group was lower than that of the control group ( P <0 .05).After treatment ,the arterial partial pressure of oxygen (PaO2 ) ,pH value ,pulse oxygen saturation(SpO2 ) increased and the arterial partial pressure of carbon dioxide (PaCO2 ) decreased in both groups .T he PaO2 ,pH value and SpO2 value in the observation group were higher than those in the control group ,and the PaCO2 level was lower than that in the control group ( P <0 .05).After treatment ,the per‐centage of vital capacity (VC) ,forced expiratory volume (FEV1) ,forced vital capacity (FVC ) ,forced expira‐tory volume (FEV1) ,forced expiratory volume (FVC ) ,forced expiratory volume (FEV1/FVC ) of the two groups increased ,and the values of VC ,FEV1 ,FVC and FEV1/FVC of the observation group were higher than those of the control group ( P <0 .05 ).[Conclusion]Early respiratory function exercise combined with nasal high flow oxygen therapy for T OF can effectively improve the quality of life ,shorten hospitalization time ,improve the blood gas index and pulmonary function of children with T OF ,and has high safety .