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腹壁成形术患者的术前呼吸物理治疗

Preoperative Respiratory Physiotherapy in Abdominoplasty Patients.

作者信息

Rodrigues Maria Amélia, Ferreira Lydia Masako, de Carvalho Calvi Eliziane Nitz, Nahas Fábio Xerfan

机构信息

Federal University of São Paulo, São Paulo, SP, Brazil.

出版信息

Aesthet Surg J. 2018 Feb 15;38(3):291-299. doi: 10.1093/asj/sjx121.

Abstract

BACKGROUND

After abdominoplasty, patients experience decreased ventilatory function and increased intra-abdominal pressure (IAP). Breathing exercises are used during the pre- and postoperative periods of several abdominal surgeries to prevent or minimize postoperative complications.

OBJECTIVES

The aim of this study was to assess the effect of preoperative respiratory physiotherapy on the outcome of abdominoplasty patients.

METHODS

Thirty-three patients were divided into 2 groups. The control group (n = 18) received no preoperative intervention. The intervention group (n = 15) performed breathing exercises during the preoperative period, including incentive spirometry, diaphragmatic breathing, shortened expiration, and sustained maximal inspiration. Respiratory physiotherapy started one week before surgery. Breathing exercises were performed daily. They were performed 3 times weekly in the presence of a physiotherapist and patients were instructed to carry on the exercises at home on days without physiotherapy sessions for three sets of 20 repetitions each. Patients were assessed by spirometry and IAP measurements.

RESULTS

No significant difference in spirometry was found between groups. However, patients in the intervention group had lower IAP at the start of surgery and at all time points (P = 0.010) compared with controls.

CONCLUSIONS

Preoperative respiratory physiotherapy had no impact on spirometry, but may have contributed to reduce IAP intraoperatively.

摘要

背景

腹壁成形术后,患者会出现通气功能下降和腹内压升高。在几种腹部手术的术前和术后阶段,都会进行呼吸锻炼以预防或减少术后并发症。

目的

本研究旨在评估术前呼吸物理治疗对腹壁成形术患者预后的影响。

方法

33例患者分为两组。对照组(n = 18)未接受术前干预。干预组(n = 15)在术前进行呼吸锻炼,包括激励式肺量计训练、膈肌呼吸、缩短呼气和持续最大吸气。呼吸物理治疗在手术前一周开始。呼吸锻炼每天进行。在物理治疗师在场的情况下每周进行3次,并且指导患者在没有物理治疗的日子里在家中进行锻炼,每组20次,共三组。通过肺量计和腹内压测量对患者进行评估。

结果

两组之间在肺量计检查方面未发现显著差异。然而,与对照组相比,干预组患者在手术开始时及所有时间点的腹内压均较低(P = 0.010)。

结论

术前呼吸物理治疗对肺量计检查无影响,但可能有助于术中降低腹内压。

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