主动呼吸循环技术对冠状动脉搭桥术后患者呼吸肌力的效果研究

Effect of the active cycle of breathing technique on respiratory muscle training in patients undergoing coronary artery bypass grafting surgery

目的评价主动呼吸循环技术对冠状动脉搭桥患者呼吸肌力的干预效果。方法采用类试验的研究方法,便利抽样选取2019年1—4月的84例行择期冠状动脉搭桥手术患者为对照组,采用常规心脏术后围手术期呼吸训练方法;选取2019年5—10月的82例行择期冠状动脉搭桥手术患者为干预组,在常规呼吸训练基础上加入主动呼吸循环技术的训练。2组患者的训练贯穿整个住院期间,每天进行3~5次。观察主要结局指标:最大吸气负压(MIP)、呼气峰流量(PEF)、用力肺活量(FVC);次要结局指标:肺部并发症的发生率、术后住院天数情况。结果对照组拔管后3 d的MIP值、PEF值、FVC值分别为(64.77±9.80)cmH2O(1 cmH2O=0.098 kPa)、(139.52±23.74)L/min、(1.07±0.20)L,干预组分别为(69.89±10.92)cmH2O、(150.37±28.65)L/min、(1.15±0.22)L,2组比较差异有统计学意义(t值为-3.177、-2.657、-2.409,均P<0.05);对照组拔管后5 d的MIP值、PEF值、FVC值分别为(71.13±8.64)cmH2O、(270.48±44.36)L/min、(2.02±0.29)L,干预组分别为(74.72±12.48)cmH2O、(287.07±58.61)L/min、(2.21±0.35)L,2组比较差异有统计学意义(t值为-2.161、-2.060、-3.605,均P<0.05)。对照组和干预组术后住院天数分别为(8.15±0.98)、(7.80±1.23)d,差异有统计学意义(t值为2.021,P<0.05)。结论主动呼吸循环技术对于冠状动脉搭桥术后患者是一种经济有效的肺康复措施,对呼吸肌力有改善作用。

Objective To evaluate the effect of active cycle of breathing techniques(ACBT)on respiratory muscle training in patients undergoing coronary artery bypass grafting(CABG)surgery.Methods A quasi-experimental trial was performed.Patients were allocated to the control group or intervention group according to their time of admission.Patients who were admitted to hospital from January 2019 to April 2019 were assigned to the control group and patients admitted from May 2019 to October 2019 were allocated to the intervention group.The control group(n=84)received routine perioperative care,and the intervention group(n=82)received ACBT in addition to routine perioperative care.Patients in both groups were trained 3 to 5 times a day throughout their stay in the hospital.The primary outcome measure was maximum inspiratory pressure(MIP),peak of expiratory flow(PEF),forced vital capacity(FVC).Other outcomes included the postoperative pulmonary complications(PPC),days of postoperative hospital stay.Results The MIP,PEF,FVC value of the control group 3 days after extubation were(64.77±9.80)cmH2O(1 cmH2O=0.098 kPa),(139.52±23.74)L/min,(1.07±0.20)L,the intervention group were(69.89±10.92)cmH2O,(150.37±28.65)L/min,(1.15±0.22)L,the differences between the two groups were statistically significant(t values were-3.177,-2.657,-2.409,P<0.05).The MIP,PEF,FVC value of the control group 5 days after extubation were(71.13±8.64)cmH2O,(270.48±44.36)L/min,(2.02±0.29)L,the intervention group were(74.72±12.48)cmH2O,(287.07±58.61)L/min,(2.21±0.35)L,the differences between the two groups were statistically significant(t values were-2.161,-2.060,-3.605,P<0.05).The days of postoperative hospital stay of control group and intervention group were(8.15±0.98)and(7.80±1.23)d,there were significant differences(t value was 2.021,P<0.05).Conclusions ACBT is an effective and economical pulmonary rehabilitation method,it has effect on Respiratory Muscle Training in Patients Undergoing CABG surgery.