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一项关于 IS 在脊柱和骨科围手术期肺功能训练中应用的横断面研究。

A Cross-Sectional Study on the Application of IS in Perioperative Pulmonary Function Training in Spine and Orthopedics.

机构信息

Infection Control Administration Department, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.

出版信息

Comput Intell Neurosci. 2022 Jul 6;2022:4546549. doi: 10.1155/2022/4546549. eCollection 2022.

Abstract

BACKGROUND

The incentive spirometer (IS) is a mechanical device that promotes lung expansion and can be used to prevent and treat postoperative pulmonary complications. In this study, the preventive effect of pulmonary function training with IS on the improvement of pulmonary function and pulmonary complications was observed.

METHODS

From May 2019 to April 2021, 69 scoliosis patients with impaired moderate and severe lung function were divided into the traditional pulmonary training group ( = 32) and IS-enhanced pulmonary training group ( = 35). The patient underwent lung function testing after admission and one week after the start of training and chest CT on the third day after surgery.

RESULTS

The average age was 13.47 and 15.66, respectively ( = 0.223). The Cobb angles were 83.84 and 83.97 ( = 0.756), respectively, and no statistical difference between the parameters of lung function was detected. After 1 week of respiratory function training, significant improvement in lung function testing parameters including VC%, FVC%, FEV1%, FEV1/FVC, FEV1/VC, and MVV% was found in both groups. Analysis of covariance showed more significant improvement in IS-enhanced group compared to the conventional training group ( < 0.05). The incidence of postoperative pulmonary atelectasis was lower in IS-enhanced group than in traditional groups (2.9% vs. 21.9%,  = 0.043) with no difference in the overall incidence of pulmonary complications ( = 0.164) and shorter preoperative and total hospitalization in the IS-enhanced group.

CONCLUSION

Compared to traditional pulmonary function training, IS-enhanced training can significantly accelerate the improvement of pulmonary function testing parameters, shorten the preoperative pulmonary function training time, reduce the incidence of postoperative pulmonary tension complications, and accelerate postoperative rehabilitation.

摘要

背景

激励式肺活量计(IS)是一种促进肺扩张的机械装置,可用于预防和治疗术后肺部并发症。本研究观察了 IS 肺功能训练对改善肺功能和肺部并发症的预防作用。

方法

2019 年 5 月至 2021 年 4 月,将 69 例中重度肺功能受损的脊柱侧弯患者分为传统肺功能训练组(n=32)和 IS 增强型肺功能训练组(n=35)。患者入院后和训练开始后一周进行肺功能检查,术后第三天进行胸部 CT 检查。

结果

两组患者的平均年龄分别为 13.47 岁和 15.66 岁( = 0.223),Cobb 角分别为 83.84°和 83.97°( = 0.756),两组肺功能参数无统计学差异。经过 1 周的呼吸功能训练,两组患者的肺活量测试参数,包括 VC%、FVC%、FEV1%、FEV1/FVC、FEV1/VC 和 MVV%,均有显著改善。协方差分析显示,IS 增强组的改善更为显著,与传统训练组相比( < 0.05)。IS 增强组术后肺不张的发生率低于传统组(2.9%比 21.9%, = 0.043),两组肺部并发症总发生率无差异( = 0.164),IS 增强组术前和总住院时间较短。

结论

与传统肺功能训练相比,IS 增强训练可显著加快肺功能测试参数的改善,缩短术前肺功能训练时间,降低术后肺部张力并发症的发生率,促进术后康复。

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Perspectives on Incentive Spirometry Utility and Patient Protocols.激励肺活量测定法的应用前景及患者方案
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Epidemiology of adolescent idiopathic scoliosis.青少年特发性脊柱侧凸的流行病学
J Child Orthop. 2013 Feb;7(1):3-9. doi: 10.1007/s11832-012-0457-4. Epub 2012 Dec 11.

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