术前吸气肌训练对预防二尖瓣介入术患者术后肺部并发症及心肺功能的影响

Effect of preoperative inspiratory muscle training on the prevention of postoperative pulmonary complications and cardiopulmonary function in patients with mitral valve intervention

目的 探究二尖瓣介入术患者进行术前吸气肌训练对预防术后肺部并发症及心肺功能的影响。方法 将需进行二尖瓣介入术患者74例依据随机数字表法分为参照组(37例)、试验组(37例)。参照组术前进行常规干预方案,试验组术前在参照组基础上进行吸气肌训练,均于术前干预5 d。将两组患者术后并发症,术前5 d与术后5 d心功能、肺功能,术前5 d及术后5、10 d世界卫生组织生存质量量表(WHOQOL)、焦虑抑郁量表(HADS)评分进行比较。结果 参照组、试验组术后并发症发生率占21.62%、5.41%,试验组比参照组更低;两组术后5 d左心室血流传播速度相较于术前5 d加快,试验组比参照组更快;左心房容积相较于术前5 d减小,试验组比参照组更小;第1秒用力呼气容积占预计值百分比相较于术前5 d降低,试验组比参照组升高;两组术后5 d最大代谢量、最大摄氧量、最大每搏摄氧量相较于术前5 d增加,试验组比参照组更高;两组术后5、10 d WHOQOL评分相较于术前5 d升高,试验组比参照组更高;HADS评分相较于术前5 d降低,试验组比参照组更低(P<0.05)。结论 二尖瓣介入术患者进行术前吸气肌训练可降低患者术后并发症发生风险,促进心功能恢复,恢复患者肺摄氧能力,提高生活质量,改善其不良情绪。

Objective To explore the effect of preoperative inspiratory muscle training on preven-ting postoperative pulmonary complications and cardiopulmonary function.Methods A total of 74 patients were divided into reference group(37 cases)and test group(37 cases)according to the random number table method.The patients in the reference group had routine preoperative intervention program,and the patients in the trial group underwent inspiratory muscle training on the basis of the reference group,all for 5 d.Two postoperative complications of patients,5 d before and 5 d postoperative cardiac function,lung function,5 d before and 5,10 d postoperative World Health Organization quality of survival scale(WHOQOL),anxiety and depression scale(HADS)score.Results The incidence of postoperative complications in the reference and test groups was 21.62%and 5.437%,The test group is lower than the reference group;In both groups,left ventricular blood flow was accelerated 5 d after surgery compared to 5 d before sur-gery,The test group is faster than the reference group;Left atrial volume decreased compared to 5 d,The test group was smaller than the reference group;The decrease of forced expiratory vol-ume in the expected value compared to 5 d before surgery,The test group is increased than the reference group;In both groups,the maximum metabolic volume,maximum oxygen uptake and maximum oxygen intake per stroke increased at 5 d compared to 5 d before surgery,The test group is higher than the reference group;The 5 and 10 d WHOQOL scores compared to 5 d be-fore surgery,The test group is higher than the reference group;HADS score compared to 5 d,The test group was lower than the reference group(P<0.05).Conclusion Preoperative inspir-atory muscle training in patients with mitral valve intervention can reduce the risk of postopera-tive complications,promote cardiac function recovery,restore pulmonary oxygen uptake,im-prove the quality of life,and improve their bad mood.