Westerdahl Elisabeth, Lindmark Birgitta, Eriksson Tomas, Hedenstierna Göran, Tenling Arne
Department of Medical Sciences, Clinical Physiology, University Hospital, Uppsala, Sweden.
Scand Cardiovasc J. 2003 Dec;37(6):363-7. doi: 10.1080/14017430310014984.
Objective--To investigate the effects of deep breathing performed on the second postoperative day after coronary artery bypass graft surgery. Design--The immediate effects of 30 deep breaths performed without a mechanical device (n = 21), with a blow bottle device (n = 20) and with an inspiratory resistance-positive expiratory pressure mask (n = 20) were studied. Spiral computed tomography and arterial blood gas analyses were performed immediately before and after the intervention. Results--Deep breathing caused a significant decrease in atelectatic area from 12.3 +/- 7.3% to 10.2 +/- 6.7% (p < 0.0001) of total lung area 1 cm above the diaphragm and from 3.9 +/- 3.5% to 3.3 +/- 3.1% (p < 0.05) 5 cm above the diaphragm. No difference between the breathing techniques was found. The aerated lung area increased by 5% (p < 0.001). The PaO (2) increased by 0.2 kPa (p < 0.05), while PaCO (2) was unchanged in the three groups. Conclusion--A significant decrease of atelectatic area, increase in aerated lung area and a small increase in PaO (2) were found after performance of 30 deep breaths. No difference between the three breathing techniques was found.
目的——研究冠状动脉搭桥手术后第二天进行深呼吸的效果。设计——研究了在无机械装置（n = 21）、使用吹瓶装置（n = 20）和使用吸气阻力-呼气末正压面罩（n = 20）的情况下进行30次深呼吸的即时效果。在干预前后立即进行螺旋计算机断层扫描和动脉血气分析。结果——深呼吸使膈肌上方1 cm处全肺面积的肺不张面积从12.3±7.3%显著降至10.2±6.7%（p < 0.0001），在膈肌上方5 cm处从3.9±3.5%降至3.3±3.1%（p < 0.05）。未发现呼吸技术之间存在差异。通气肺面积增加了5%（p < 0.001）。三组患者的PaO₂增加了0.2 kPa（p < 0.05），而PaCO₂无变化。结论——进行30次深呼吸后，肺不张面积显著减小，通气肺面积增加，PaO₂略有增加。三种呼吸技术之间未发现差异。
