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早期活动对冠状动脉旁路移植术后肺功能参数和并发症的影响。

Effects of early mobilization on pulmonary parameters and complications post coronary artery bypass graft surgery.

机构信息

Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran.

Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Appl Nurs Res. 2023 Feb;69:151653. doi: 10.1016/j.apnr.2022.151653. Epub 2022 Dec 17.

Abstract

This study compared the effects of a four-phase and a three-phase early mobilization protocol on respiratory parameters and complications in patients following coronary artery bypass graft surgery. This is a three-arm, parallel-group, randomized controlled clinical trial with 120 candidates for coronary artery bypass graft surgery. Participants were randomly allocated to three groups: four-phase early mobilization protocol, three-phase early mobilization protocol, and control. Arterial blood gases, oxygen saturation, and incidence of pulmonary complications were compared among the groups. Mean arterial blood gases and oxygen saturation improved significantly over time in both four-phase early mobilization protocol and three-phase early mobilization protocol groups compared to control (p < 0.05). There were observed trends for greater improvements in the study outcomes with three-phase early mobilization protocol than four-phase early mobilization protocol; however, did not reach statistically significant levels. The incidence of pulmonary complications was significantly in both intervention groups compared to control (odds ratio: 0.48, 95 % CI 0.007-0.537; p < 0.001). Both four-phase early mobilization and the three-phase early mobilization protocols improved respiratory parameters and reduced pulmonary complications. Statistically insignificant trends were found trends in the three-phase early mobilization protocol, focusing on chest physiotherapy and breathing exercises.

摘要

这项研究比较了四阶段和三阶段早期活动方案对冠状动脉旁路移植术后患者呼吸参数和并发症的影响。这是一项三臂、平行组、随机对照临床试验,共纳入 120 例冠状动脉旁路移植术候选患者。参与者被随机分配到三组:四阶段早期活动方案组、三阶段早期活动方案组和对照组。比较各组动脉血气、血氧饱和度和肺部并发症发生率。与对照组相比,四阶段早期活动方案组和三阶段早期活动方案组的平均动脉血气和血氧饱和度随时间明显改善(p<0.05)。虽然三阶段早期活动方案组的研究结果有更大改善的趋势,但未达到统计学显著水平。与对照组相比,两组干预组肺部并发症的发生率均显著降低(比值比:0.48,95%CI 0.007-0.537;p<0.001)。四阶段早期活动和三阶段早期活动方案均改善了呼吸参数并减少了肺部并发症。虽然三阶段早期活动方案有统计学上不显著的趋势,但重点是胸部物理疗法和呼吸练习。

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