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蹬车测力器对冠状动脉旁路移植术后老年患者心肺功能的影响:临床试验

Effects of Cycloergometer on Cardiopulmonary Function in Elderly Patients after Coronary Artery Bypass Grafting: Clinical Trial.

作者信息

Cordeiro André Luiz Lisboa, Barbosa Hayssa De Cássia Mascarenhas, Vaz Kaliane Pereira, Souza Layla Souza E, Souza Laura Brandão De, Matos Thayná De Oliveira, Guimarães André Raimundo França

机构信息

Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.

Nobre University Center, Feira de Santana, Bahia, Brazil.

出版信息

Cardiol Res Pract. 2024 Sep 20;2024:3808437. doi: 10.1155/2024/3808437. eCollection 2024.

Abstract

INTRODUCTION

Despite all the improvements in surgical and anesthetic techniques, this procedure is still associated with pulmonary and cardiovascular complications in the postoperative period, and early rehabilitation, done through the use of cycloergometer, can minimize such complications, besides reducing the length of hospital stay.

OBJECTIVE

Therefore, the aim of the study was to assess the impact of cardiovascular exercise on lung function, respiratory muscle strength, and functional capacity in elderly patients after heart bypass surgery.

METHODS

To this purpose, a randomized and controlled clinical trial was conducted. Research participants were randomized to the cycle ergometer group (CEG) or to the control group (CG). The CG was managed based on the institution's protocol. The CEG also carried out all the activities of the control group, but there was the inclusion of cycle ergometry through a device built by the researchers. Pulmonary function (vital capacity (VC) and peak expiratory flow (PEF)), ventilatory muscle strength (maximum inspiratory pressure (MIP) and maximal expiratory pressure (MEP)), and functional capacity (six-minute walk test) were evaluated before surgery, at ICU, and hospital discharge.

RESULTS

During the research period, 122 patients were evaluated, 61 in each group. The MIP of the cycle ergometry group was higher at discharge from the ICU 95% CI 8 (5.46 to 10.54) and at hospital discharge 95% CI 14 (16.89 to 11.11). MEP was higher in the cycle ergometry group at discharge from the ICU with 95% CI 6 (8.18 to 3.82) and at hospital discharge with 95% CI 9 (11.69 a 6.31). Vital capacity at ICU discharge with 95% CI 6 (7.98 to 4.02) and at hospital discharge with 95% CI 7 (8.98 to 5.02), as well as peak flow at ICU discharge with 95% CI 43 (75.27 to 10.73), showed relevance, being higher in the group that used the cycle ergometer. The CEG showed improvement in functional capacity at the time of hospital discharge with a 95% CI 56 (30.37 to 81.63).

CONCLUSION

We conclude that application of cycloergometry after CABG decreases the loss of pulmonary function, muscle strength, and functional capacity. This trial is registered with RBR-39yrht6.

摘要

引言

尽管手术和麻醉技术有了诸多改进,但该手术在术后仍会出现肺部和心血管并发症,而通过使用手摇测力计进行早期康复训练,除了能缩短住院时间外,还可将此类并发症降至最低。

目的

因此,本研究旨在评估心血管运动对心脏搭桥手术后老年患者肺功能、呼吸肌力量和功能能力的影响。

方法

为此,开展了一项随机对照临床试验。研究参与者被随机分为手摇测力计组(CEG)或对照组(CG)。对照组按照医院的方案进行管理。手摇测力计组除了开展对照组的所有活动外,还通过研究人员自制的设备进行手摇测力计训练。在手术前、重症监护病房(ICU)和出院时评估肺功能(肺活量(VC)和呼气峰值流量(PEF))、通气肌力量(最大吸气压力(MIP)和最大呼气压力(MEP))以及功能能力(六分钟步行试验)。

结果

在研究期间,共评估了122例患者,每组61例。手摇测力计组的最大吸气压力在ICU出院时更高,95%置信区间为8(5.46至10.54),在出院时更高,95%置信区间为14(16.89至11.11)。手摇测力计组的最大呼气压力在ICU出院时更高,95%置信区间为6(8.18至3.82),在出院时更高,95%置信区间为9(11.69至6.31)。肺活量在ICU出院时95%置信区间为6(7.98至4.02),在出院时95%置信区间为7(8.98至5.02),以及呼气峰值流量在ICU出院时95%置信区间为43(75.27至10.73),均显示出差异,使用手摇测力计的组更高。手摇测力计组在出院时功能能力有所改善,95%置信区间为56(30.37至81.63)。

结论

我们得出结论,冠状动脉旁路移植术后应用手摇测力计可减少肺功能、肌肉力量和功能能力的损失。本试验已在RBR - 39yrht6注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1267/11436265/82f5f077a02a/CRP2024-3808437.001.jpg

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