中医肺康复疗法在肺挫伤合并多发肋骨骨折围术期救治中的应用

Application of Lung Rehabilitation Therapy of Chinese Medicine in Perioperative Treatment of Pulmonary Contusion Complicated with Multiple Rib Fractures

目的:观察中医肺康复疗法在肺挫伤合并多发肋骨骨折围术期救治中的应用效果。方法:选取接受手术治疗的肺挫伤合并多发肋骨骨折患者作为研究对象,共85例,脱落5例,最终纳入研究80例。2组均予手术治疗,术后予抗感染及止痛等处理。对照组40例在围术期予常规处理,研究组40例在围术期开始采取中医肺康复疗法。比较2组术后的肺功能指标、血气分析结果以及肺部并发症发生率等。结果:术后1周,2组动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、氧合指数(P/F)及呼气峰值流速(PEF)水平均较入院时明显升高,差异均有统计学意义(P<0.05);2组动脉血二氧化碳分压(PaCO_(2))及第1秒用力呼气容积(FEV1)水平比较,差异均无统计学意义(P>0.05)。研究组术后1周PaO_(2)、SaO_(2)、P/F及PEF水平均高于对照组,差异均有统计学意义(P<0.05)。术后1周,2组血清血清肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)水平均较入院时明显降低,且研究组TNF-α、CRP、IL-6水平均显著低于对照组,差异均有统计学意义(P<0.05)。研究组术后并发症总发生率10.00%,明显低于对照组35.00%,差异均有统计学意义(P<0.05)。研究组术后住院时间明显短于对照组,差异均有统计学意义(P<0.05);2组住院费用接近,差异无统计学意义(P>0.05)。结论:在围术期对肺挫伤合并多发肋骨骨折患者实施中医肺康复治疗能够有效抑制炎症反应,改善肺功能,减少肺部并发症的发生,缩短康复时间。

Objective:To observe the application effect of lung rehabilitation therapy of Chinese medicine in perioperative treatment of pulmonary contusion complicated with multiple rib fractures.Methods:A total of 85 cases of patients with pulmonary contusion complicated with multiple rib fractures,who received surgery,were selected as the research object.Five cases of patients were lost and finally 80 cases were included in the study,with 40 cases in the control group and the study group respectively.Both groups were given surgery,and treatments including anti-infection and pain relief after surgery.The control group was given routine treatment in perioperative period,and the study group was given lung rehabilitation therapy of Chinese medicine in perioperative period.The indexes of lung function,the blood gas analysis results and the incidence of pulmonary complications after surgery in the two groups were compared.Results:At one week after surgery,the levels of partial pressure of oxygen(PaO_(2)),oxygen saturation(SaO_(2)),oxygenation index(P/F)and peak expiratory flow(PEF)in the two groups were significantly increased when compared with those at admission,differences being significant(P<0.05);there was no significant difference being found in the comparison of levels of partial pressure of carbon dioxide(PaCO_(2))and forced expiratory volume in one second(FEV1)between the two groups.At one week after surgery,the levels of PaO_(2),SaO_(2),P/F and PEF in the study group were higher than those in the control group,differences being significant(P<0.05).At one week after surgery,tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6)in the two groups were significantly decreased when compared with those at admission,and the levels of TNF-α,CRP and IL-6 in the study group were significantly lower than those in the control group,differences being significant(P<0.05).The total incidence of complications after surgery was 10.00%in the study group,significantly lower than that of35.00%in the control group,differences being significant(P<0.05).The hospitalization time in the study group was significantly shorter than that in the control group,differences being significant(P<0.05);the hospitalization expenses in the two groups were similar,there being no significance in the difference(P>0.05).Conclusion:In the perioperative period,the application of lung rehabilitation therapy of Chinese medicine for patients with pulmonary contusion complicated with multiple rib fractures can effectively inhibit the inflammatory responses,improve lung function,reduce the incidence of complications in the lung,and shorten the rehabilitation time.