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[激励式肺量计作为胸科和食管手术后预防术后呼吸并发症的传统物理治疗辅助手段的无效性]

[Ineffectiveness of incentive spirometry as coadjuvant of conventional physiotherapy for the prevention of postoperative respiratory complications after thoracic and esophageal surgery].

作者信息

Vilaplana J, Sabaté A, Ramon R, Gasolibe V, Villalonga R

机构信息

Departamento de Anestesiología y Reanimación, Hospital de Bellvitge Prínceps d'Espanya, L'Hospitalet de Llobregat, Barcelona.

出版信息

Rev Esp Anestesiol Reanim. 1990 Nov-Dec;37(6):321-5.

PMID:2098873
Abstract

We have studied the efficacy of routine use of incentive spirometry (IS) in two groups of patients: group 1 (n = 18) with IS, and group 2 (n = 19), no IS. All patients suffered from lung or esophagus neoplasm and received respiratory physiotherapy before and after the operation. They underwent high chest and abdomen surgery. The incidence of alterations of pulmonary auscultation, roentgenologic abnormalities and alterations of the alveolar-arterial difference of oxygen (D[A-a]O2) as well as postoperative complications were similar in both groups. Patients undergoing digestive surgery presented a higher frequency of pleural effusion (p less than 0.05) and of them, the subgroup with IS stayed at the hospital for a longer time (47.2 +/- 32 days) than the subgroup undergoing digestive surgery not submitted to IS (p less than 0.01) probably because of the higher incidence of neoplasms of the mean third of the esophagus in such group. In our study and in the context of the type of surgery studied, the routine use of IS does not decrease the frequency of clinical and roentgenologic alterations neither improves the efficacy of postoperative gas interchange.

摘要

我们研究了两组患者常规使用激励肺活量测定法(IS)的疗效:第1组(n = 18)使用IS,第2组(n = 19)不使用IS。所有患者均患有肺部或食管肿瘤,并在手术前后接受呼吸物理治疗。他们接受了高胸腹部手术。两组患者肺部听诊改变、影像学异常、肺泡-动脉氧分压差(D[A-a]O2)改变以及术后并发症的发生率相似。接受消化手术的患者胸腔积液发生率更高(p < 0.05),其中,使用IS的亚组住院时间(47.2 ± 32天)比未接受IS的消化手术亚组更长(p < 0.01),这可能是因为该组食管中段肿瘤发生率较高。在我们的研究以及所研究的手术类型背景下,常规使用IS并不能降低临床和影像学改变的频率,也不能提高术后气体交换的疗效。

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