Cheng Wei, Chen Jianwei, Sun Jianhua, Zhang Jiahui, Li Dongkai, Wang Hao, Li Zunzhu, Cui Na
State Key Laboratory of Complex Severe and Rare Diseases Department of Critical Care Medicine,Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
Department of Critical Care Medicine, Beijing Jishuitan Hospital, Beijing, China.
Front Med (Lausanne). 2022 Feb 23;9:844094. doi: 10.3389/fmed.2022.844094. eCollection 2022.
The role of intensified lung physiotherapy bundle after cardiac surgery was investigated.
A before- and after-surgery comparison was conducted between the study from January 1, 2018 to December 31, 2019 (control group), when traditional lung physiotherapy bundle was used, and from January 1, 2020 to May 1, 2021 (study group), when the intensified bundle was used. The baseline data, clinical features, incidence of postoperative pneumonia, and prognoses of all the enrolled cardiac surgery patients were analyzed.
In accordance with the study criteria, 358 patients were enrolled. The incidence rate of postoperative pneumonia was significantly lower in the study group than in the control group (14.2 vs. 22.7%, = 0.037), as was in-hospital mortality (1.5 vs. 5.2%, = 0.043). Patients receiving the intensified lung physiotherapy bundle had much shorter mechanical ventilation time (92 vs. 144 h, < 0.0001), much shorter intensive care unit (ICU) stay (5 vs. 7 days, < 0.001), and much shorter hospital stay (17 vs. 18.5 days, = 0.022). The intensified lung physiotherapy bundle was an independent protective factor enabling the reduced occurrence of pneumonia ( = 0.007). On univariate analysis, this bundle significantly improved in-hospital mortality ( = 0.043).
Our intensified lung physiotherapy bundle potentially reduces the rate of postoperative pneumonia after cardiac surgery. This bundle might also be adopted as a suitable reference guide for the prevention of other postoperative pulmonary complications.
研究强化肺物理治疗方案在心脏手术后的作用。
对2018年1月1日至2019年12月31日（对照组）采用传统肺物理治疗方案，以及2020年1月1日至2021年5月1日（研究组）采用强化治疗方案的心脏手术患者进行术前和术后对比。分析所有纳入的心脏手术患者的基线数据、临床特征、术后肺炎发生率及预后情况。
按照研究标准，共纳入358例患者。研究组术后肺炎发生率显著低于对照组（14.2%对22.7%，P = 0.037），住院死亡率也较低（1.5%对5.2%，P = 0.043）。接受强化肺物理治疗方案的患者机械通气时间明显缩短（92小时对144小时，P < 0.0001），重症监护病房（ICU）住院时间明显缩短（5天对7天，P < 0.001），住院时间也明显缩短（17天对18.5天，P = 0.022）。强化肺物理治疗方案是降低肺炎发生率的独立保护因素（P = 0.007）。单因素分析显示，该方案显著改善了住院死亡率（P = 0.043）。
我们的强化肺物理治疗方案可能降低心脏手术后的术后肺炎发生率。该方案也可作为预防其他术后肺部并发症的合适参考指南。
