CAJ | 학술논문

目的通过对脊柱侧凸矫形术患者术前呼吸功能渐进式训练方法,提高患者术前的肺功能指标,增强脊柱侧凸患者术前耐受手术的能力,减少手术中意外风险的发生.方法选择2011年7月至2012年7月收治的70例脊柱侧凸患者,术前进行呼吸功能渐进式训练,训练周期为7 ～10d,由1名专职护士负责指导、评估和记录,训练前后进行肺功能指标检测,包括肺活量、最大通气量及分别占预计值的百分比.结果脊柱侧凸患者呼吸训练后平均最大吸气值、训练频率分别为(1 877.22±672.21) ml,(320.60±123.40)次/d,均高于训练前的(1 466.12±720.10)ml,(102.40±48.20)次/d,差异均有统计学意义(t分别为4.02,6.88;P ＜0.01)；训练前后患者脉搏频率、血氧饱和度比较,差异均无统计学意义(P＞0.05).训练后患者肺活量、肺活量占预计值的百分比、最大通气量、最大通气量占预计值的百分比分别为(2.48±0.70)L,(70.40±12.34)％,(58.21±10.01)L,(90.44±15.40)％,均高于训练前的(1.80±0.65)L,(62.34±10.17)％,(47.02±11.32)L,(83.80±13.20)％,差异均有统计学意义(t分别为3.51,2.88,4.15,3.33;P ＜0.01).结论对脊柱侧凸患者术前进行渐进式呼吸功能训练,有效提高了患者术前呼吸功能的效果,最大限度地提高了深吸气值,增强了肺功能,对脊柱侧凸患者适应手术要求并减少手术中危险因素,及术后进一步实施呼吸功能训练提供了技术支持,值得临床推广应用.
목적 통과대척주측철교형술환자술전호흡공능점진식훈련방법,제고환자술전적폐공능지표,증강척주측철환자술전내수수술적능력,감소수술중의외풍험적발생.방법 선택2011년7월지2012년7월수치적70례척주측철환자,술전진행호흡공능점진식훈련,훈련주기위7 ～10d,유1명전직호사부책지도、평고화기록,훈련전후진행폐공능지표검측,포괄폐활량、최대통기량급분별점예계치적백분비.결과 척주측철환자호흡훈련후평균최대흡기치、훈련빈솔분별위(1 877.22±672.21) ml,(320.60±123.40)차/d,균고우훈련전적(1 466.12±720.10)ml,(102.40±48.20)차/d,차이균유통계학의의(t분별위4.02,6.88;P ＜0.01)；훈련전후환자맥박빈솔、혈양포화도비교,차이균무통계학의의(P＞0.05).훈련후환자폐활량、폐활량점예계치적백분비、최대통기량、최대통기량점예계치적백분비분별위(2.48±0.70)L,(70.40±12.34)％,(58.21±10.01)L,(90.44±15.40)％,균고우훈련전적(1.80±0.65)L,(62.34±10.17)％,(47.02±11.32)L,(83.80±13.20)％,차이균유통계학의의(t분별위3.51,2.88,4.15,3.33;P ＜0.01).결론 대척주측철환자술전진행점진식호흡공능훈련,유효제고료환자술전호흡공능적효과,최대한도지제고료심흡기치,증강료폐공능,대척주측철환자괄응수술요구병감소수술중위험인소,급술후진일보실시호흡공능훈련제공료기술지지,치득림상추엄응용.
Objective To improve indexes of pre-operative pulmonary function and operative tolerance,as well as to avoid accidental risks during operation by using gradual training methods of breathing function for patients with scoliosis.Methods Totals of 70 patients with scoliosis from July 2011 to July 2012 were chosen and trained with gradual methods of breathing function for 7 to 10 days.One nurse was in charge of guidance,evaluation and recording.Indexes of pulmonary function,including breathing capacity,maximal ventilatory capacity and percentages among predicted value,were compared before and after training.Results Average maximal ventilatory capacity and training frequency were respectively (1 877.22 ± 672.21)ml and (320.60 ±123.40) times/d after training,both higher than (1 466.12 ± 720.10) ml and (102.40 ± 48.20) times/d before training,and the differences were statistically significant (t =4.02,6.88,respectively; P ＜ 0.01).There was no statistically significant difference of pulses and degree of blood oxygen saturation before and after training.Breathing capacity and its percentage among predicted value,maximal ventilatory capacity and its percentage among predicted value were respectively (2.48 ± 0.70) L,(70.40 ± 12.34) ％,(58.21 ± 10.01) L and (90.44 ± 15.40) ％ after training,all of which were higher than (1.80 ± 0.65) L,(62.34 ± 10.17) ％,(47.02 ± 11.32)L and (83.80 ± 13.20)％ before training,and the differences were statistically significant (t =3.51,2.88,4.15,3.33,respectively; P ＜ 0.01).Conclusions Gradual training methods of breathing function on patients with scoliosis can improve their pre-operative pulmonary function,which provides technical support for patients' adoption to operations,reduction of risks and further training of breathing function,thus worthy of promotion.