Hall J C, Tarala R, Harris J, Tapper J, Christiansen K
University Department of Surgery, Department of Respiratory Medicine, Royal Perth Hospital, Australia.
Lancet. 1991 Apr 20;337(8747):953-6. doi: 10.1016/0140-6736(91)91580-n.
We entered 876 patients into a clinical trial aimed at preventing pulmonary complications after abdominal surgery. Patients either received conventional chest physiotherapy or were encouraged to perform maximal inspiratory manoeuvres for 5 min during each hour while awake, using an incentive spirometer. The incidence of pulmonary complications did not differ significantly between the groups: incentive spirometry 68 of 431 (15.8%, 95% CI 14.0-17.6%), and chest physiotherapy 68 of 445 (15.3%, CI 13.6-17.0%). Nor was there a difference between the groups in the incidence of positive clinical signs, pyrexia, abnormal chest radiographs, pathogens in sputum, respiratory failure (PO2 less than 60 mm Hg), or length of stay in hospital. We conclude that prophylactic incentive spirometry and chest physiotherapy are of equivalent clinical efficacy in the general management of patients undergoing abdominal surgery.
我们将876例患者纳入一项旨在预防腹部手术后肺部并发症的临床试验。患者要么接受传统的胸部物理治疗，要么在清醒时每小时使用激励肺活量计进行5分钟的最大吸气动作。两组之间肺部并发症的发生率没有显著差异：激励肺活量计组431例中有68例（15.8%，95%可信区间14.0 - 17.6%），胸部物理治疗组445例中有68例（15.3%，可信区间13.6 - 17.0%）。两组在阳性临床体征、发热、胸部X光片异常、痰中病原体、呼吸衰竭（动脉血氧分压低于60 mmHg）或住院时间的发生率方面也没有差异。我们得出结论，在接受腹部手术患者的一般管理中，预防性激励肺活量计和胸部物理治疗具有同等的临床疗效。
