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阿凯拉(Acapella)联合基于机构的胸部物理治疗技术对冠状动脉旁路移植术(CABG)术后患者肺功能和气道清除的有效性。

Effectiveness of Acapella along with institutional based chest physiotherapy techniques on pulmonary functions and airway clearance in post-operative CABG patients.

作者信息

Jage Bhagyashree, Thakur Anuprita

机构信息

School of Physiotherapy, D. Y. Patil University Navi Mumbai, Maharashtra, India.

出版信息

Hong Kong Physiother J. 2022 Dec;42(2):81-89. doi: 10.1142/S101370252250007X. Epub 2022 Jun 15.

Abstract

BACKGROUND

Patients undergoing Coronary Artery Bypass Graft (CABG) surgery often develop pulmonary complications in the early post-operative period as result of decreased lung function and impaired cough. Conventional physiotherapy in early post-operative period aims at increasing lung volumes and airway clearance.

OBJECTIVE

This study aimed to determine the effectiveness of the addition of Acapella to conventional chest physiotherapy in improving lung volumes and secretion clearance in early post-operative CABG patients.

METHODS

Twenty patients of both genders (40-70 years) who had undergone CABG and were in Phase I of Cardiac Rehabilitation were involved in this pilot randomized control trial (9 control, 11 experimental). Post-surgery intervention commenced on post-operative day 2 (POD 2) and continued till POD 6. Patients in the control group were given conventional physiotherapy that included breathing exercises, incentive spirometry and manual techniques. Patient in the experimental group used an Acapella device along with the conventional intervention. Outcome measures considered were pulmonary function parameters (FVC, FEV1 & PEFR) and amount of sputum expectorated.

RESULTS

A significant increase in lung volumes was observed in both the groups on POD 6 as compared to POD 2 (). However, the increase was significantly greater on POD 6 in experimental group than the control group [mean difference (95% CI) FVC: 0.44 L (0.24-0.63), FEV1: 0.43 L (0.19-0.66), PEFR: 0.86 L/s (0.57-1.14)]. The amount of sputum expectoration significantly greater in the experimental group as compared to the control group [2.71 mL (0.53-4.90)].

CONCLUSION

The addition of Acapella enhanced the effect conventional physiotherapy in improving lung volumes and airway clearance in the early post-operative period for CABG patients.

摘要

背景

接受冠状动脉旁路移植术(CABG)的患者在术后早期常因肺功能下降和咳嗽功能受损而出现肺部并发症。术后早期的传统物理治疗旨在增加肺容量和清除气道分泌物。

目的

本研究旨在确定在传统胸部物理治疗中添加阿法贝拉(Acapella)对改善CABG术后早期患者肺容量和分泌物清除的有效性。

方法

本前瞻性随机对照试验纳入了20例年龄在40至70岁之间、接受CABG且处于心脏康复第一阶段的患者(9例对照组,11例试验组)。术后干预于术后第2天(POD 2)开始,持续至POD 6。对照组患者接受包括呼吸练习、激励肺活量测定和手法治疗在内的传统物理治疗。试验组患者在接受传统干预的同时使用阿法贝拉装置。所考虑的结局指标为肺功能参数(FVC、FEV1和PEFR)以及咳出的痰液量。

结果

与POD 2相比,两组患者在POD 6时肺容量均显著增加()。然而,试验组在POD 6时的增加幅度明显大于对照组[平均差值(95%CI)FVC:0.44 L(0.24 - 0.63),FEV1:0.43 L(0.19 - 0.66),PEFR:0.86 L/s(0.57 - 1.14)]。试验组咳出的痰液量明显多于对照组[2.71 mL(0.53 - 4.90)]。

结论

添加阿法贝拉可增强传统物理治疗对改善CABG术后早期患者肺容量和气道清除的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf7a/10406641/2fa21f694bad/hkpj-42-081-g001.jpg

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