达芬奇机器人房间隔缺损修补术患者围手术期呼吸功能训练的临床效果研究

Clinical Effect of Perioperative Respiratory Function Training in Patients Undergoing Da Vinci Robotic Atrial Septal Defect Repair

目的观察达芬奇机器人房间隔缺损修补术患者围手术期呼吸功能训练的临床效果。方法选取2019年1月至2019年11月达芬奇机器人房间隔缺损修补术患者35例,随机分为试验组和对照组,对照组采用常规护理措施,试验组自入院开始采用激励式肺量计和改良腹式呼吸相结合,进行呼吸功能训练,术后拔出气管插管后即进行呼吸功能训练。对比两组患者入院当日(T1)、拔管后72h(T2)、拔管后120h(T3)的血气分析、肺功能、机械通气时间和术后肺部并发症。结果试验组拔管后72h和拔管后120h的氧分压(P02)、第1秒内用力呼气总量(FEV1)、用力肺活量(FVC)、最大吸气量均显著高于对照组(P<0.01);两组患者PC02也具有统计学差异(P<0.05),但机械通气时间无显著差异(P>0.05)。试验组术后肺部感染、肺不张、低氧血症的发病率明显低于对照组。结论行达芬奇机器人房间隔缺损修补术的患者进行围手术期呼吸功能训练,能够有效改善患者术后血气,提高患者肺功能,降低术后肺部并发症的发生率,促进患者术后快速康复。

Objective To observe the clinical effect of perioperative respiratory function training in patients undergoing Da Vinci robot atrial septal defect repair.Methods 35 patients with atrial septal defect repaired by Da Vinci robot from January 2019 to November 2019 were selected and randomly divided into experimental group and control group.The control group was given routine nursing measures.The experimental group was given respiratory function training by the combination of incentive spirometer and improved abdominal breathing since admission.After the tracheal intubation was pulled out,the respiratory function training was carried out.Blood gas analysis,pulmonary function,mechanical ventilation time and postoperative pulmonary complications were compared between the two groups on the day of admission (T1),72h after extubation (T2),120h after extubation (T3).Results The partial pressure of oxygen (P02),total forced expiratory volume (FEV1),forced vital capacity (FVC) and maximum inspiratory volume in the first second in the experimental group were significantly higher than those in the control group (P<0.01);the pc02 of the two groups was also statistically different (P<0.05),but the mechanical ventilation time had no significant difference (P>0.05).The incidence rate of pulmonary infection,atelectasis and hypoxemia in the experimental group were significantly lower than those in the control group.Conclusion Perioperative respiratory function training for patients undergoing Da Vinci robot atrial septal defect repair can effectively improve the postoperative blood gas,improve the pulmonary function,reduce the incidence of postoperative pulmonary complications,and promote the rapid recovery of patients.