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间歇性正压通气和激励肺活量测定法对心肌血运重建术后的影响。

The effects of intermittent positive pressure and incentive spirometry in the postoperative of myocardial revascularization.

作者信息

Romanini Walmir, Muller Andrea Pires, Carvalho Katherine Athayde Teixeira de, Olandoski Marcia, Faria-Neto José Rocha, Mendes Felipe Luiz, Sardetto Evandro Antonio, Costa Francisco Diniz Afonso da, Guarita-Souza Luiz César

机构信息

Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil.

出版信息

Arq Bras Cardiol. 2007 Aug;89(2):94-9, 105-10. doi: 10.1590/s0066-782x2007001400006.

Abstract

BACKGROUND

Pulmonary complications are important causes of morbidity and fatalities among patients subject to cardiac surgery. The respiratory physiotherapy has been aiding in the recovery of these patient ones.

OBJECTIVE

To evaluate the physiotherapeutic effect of intermittent positive pressure breathing (IPPB) and incentive spirometry (IS) in patients submitted to myocardial revascularization surgery.

METHODS

Forty patients were divided in two groups: one was submitted to IPPB (n=20) and the other to IS (n=20). The patients were evaluated at the preoperative period and 24, 48 and 72 hours postoperatively, with the resources being applied in the postoperative period. The following parameters were analyzed: oxygen saturation (SpO2), respiratory frequency (RF), minute volume (MV), current volume (CV), maximum inspiratory pressure (Ip max) and maximum expiratory pressure (Ep max).

RESULTS

The groups were considered homogeneous regarding the demographic and clinical variables. In the group submitted to IPPB, an increase in SpO2 was observed 48 (p=0.007) and 72 h (p=0.0001) after surgery, when compared to the IS group. As for the RF, MV and CV variables, there were no statistically significant differences between the groups. The group submitted to IS showed a significant increase in the Epmax 24 (p=0.02) and 48 (p=0.01) h after surgery.

CONCLUSION

Aiming at reversing hypoxemia earlier, IPPB showed to be more efficient when compared to IS; however, IS was more effective in improving respiratory muscle strength.

摘要

背景

肺部并发症是心脏手术患者发病和死亡的重要原因。呼吸物理治疗有助于这些患者的康复。

目的

评估间歇性正压通气(IPPB)和激励肺活量测定法(IS)对接受心肌血运重建手术患者的物理治疗效果。

方法

40例患者分为两组:一组接受IPPB(n = 20),另一组接受IS(n = 20)。在术前以及术后24、48和72小时对患者进行评估,术后应用相关方法。分析以下参数:血氧饱和度(SpO2)、呼吸频率(RF)、分钟通气量(MV)、潮气量(CV)、最大吸气压力(Ip max)和最大呼气压力(Ep max)。

结果

两组在人口统计学和临床变量方面被认为具有同质性。与IS组相比,接受IPPB的组在术后48小时(p = 0.007)和72小时(p = 0.0001)观察到SpO2升高。至于RF、MV和CV变量,两组之间无统计学显著差异。接受IS的组在术后24小时(p = 0.02)和48小时(p = 0.01)Epmax显著增加。

结论

为了更早地纠正低氧血症,与IS相比,IPPB显示出更高的效率;然而,IS在改善呼吸肌力量方面更有效。

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