老年股骨粗隆骨折患者预防术后肺部并发症的系统化呼吸功能训练

Systematic respiratory training for elderly patients with trochanteric fracture of the femur to prevent the postoperative pulmonary complications

目的探讨系统化呼吸功能训练在预防老年股骨粗隆骨折患者术后肺部并发症中的应用效果。方法选择2021年7月—2023年5月入住通州区人民医院骨科为股骨粗隆间骨折行择期手术内固定的80例老年患者为研究对象。按照组间基本特征具有可比性的原则将患者分为观察组与对照组,每组40例。对照组患者常规采取围手术期肺部管理,观察组患者采取系统化的呼吸功能训练。比较两组患者研究期间的肺部并发症发生率以及护理干预前后的用力肺活量(FVC)、第一秒用力呼吸容积(FEV_(1))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))以及呼吸生活质量评分。结果观察组患者的肺部并发症发生率低于对照组,组间比较差异有统计学意义(P<0.05)。系统化的呼吸功能训练护理干预前,两组患者的FVC及FEV_(1)/FVC比较差异无统计学意义(P>0.05);护理干预后,观察组患者的FVC及FEV_(1)/FVC高于对照组,组间比较差异有统计学意义(P<0.05)。护理干预前,两组患者的PaO_(2)与PaCO_(2)比较差异无统计学意义(P>0.05);护理干预后,观察组患者的PaO_(2)高于对照组,PaCO_(2)低于对照组患者,组间比较差异有统计学意义(P<0.05)。护理干预前,两组患者的圣乔治呼吸问卷(SGRQ)评分比较差异无统计学意义(P>0.05);护理干预后,观察组患者的SGRQ评分低于对照组患者,组间比较差异有统计学意义(P<0.05)。结论在老年股骨粗隆患者围手术期给予系统化呼吸功能训练能够有效降低术后肺部并发症发生率,提高患者呼吸功能,改善血氧指标,同时也能改善患者的生活质量,加速患者的术后康复进程。

Objective To explore the application effect of systematic respiratory function training in preventing postoperative pulmonary complications in elderly patients with trochanteric fracture of femur.Methods 80 elderly patients who were admitted to the Department of Orthopaedics of Tongzhou district People's Hospital for elective surgical internal fi xation of femoral trochanteric fractures from July 2021 to May 2023 were selected as the study subjects.According to the principle of comparability of basic characteristics between groups,they were divided into observation group and control group,with 40 cases in each group.Perioperative pulmonary management was routinely adopted in the control group,and systematic respiratory function training was adopted in the observation group.The incidence of pulmonary complications during the study period was compared between the two groups of patients,as well as before and after the nursing intervention,the forceful forced vital capacity(FVC),the first second forceful breathing volume(FEV_(1)),the arterial partial pressure of oxygen(PaO_(2)),the arterial partial pressure of carbon dioxide(PaCO_(2)),and the respiratory quality of life scores.Results The incidence of pulmonary complications in the observation group was lower than that in the control group,and the difference between the groups was statistically signifi cant(P<0.05).Before the systematic respiratory function training nursing intervention,there was no statistically signifi cant difference between the FEV_(1)/FVC of the two groups(P>0.05);After the nursing intervention,the FVC and FEV_(1)/FVC of the patients in the observation group were higher than those in the control group,the difference between the groups was statistically signifi cant(P<0.05).Before nursing intervention,there was no statistically significant difference in the comparison of PaO_(2)and PaCO_(2)between the two groups(P>0.05).After nursing intervention,the PaO_(2)of patients in the observation group was higher than that of the control group,and PaCO_(2)was lower than that of patients in the control group,and there was a statistically signifi cant difference in the comparison between the groups(P<0.05).Before nursing intervention,there was no statistically signifi cant difference in the comparison of St.George's Respiratory Questionnnaire(SGRQ)scores between the two groups(P>0.05).After nursing intervention,the SGRQ scores of patients in the observation group were lower than those of patients in the control group,and the difference between the groups was statistically signifi cant(P<0.05).Conclusion To apply the systematic respiratory function training in the perioperative period of elderly patients with femoral trochanter can effectively reduce the incidence of postoperative pulmonary complications,improve the respiratory function of patients,and improve the index of blood oxygenation,as well as improve the quality of life of patients,and accelerate the process of postoperative rehabilitation of patients.