摘要
目的 构建重度脊柱侧凸患者围手术期肺康复方案,并探讨其临床应用效果。方法运用文献分析法和专家咨询构建重度脊柱侧凸患者围手术期肺康复方案。采用方便抽样法,选择杭州市某三级甲等医院骨科2021年7月-2022年10月收治的28例重度脊柱侧凸患者作为试验组,2020年1月-2021年6月收治的30例重度脊柱侧凸患者作为对照组。试验组在常规护理基础上采用重度脊柱侧凸患者围手术期肺康复方案,对照组采用常规护理,比较两组肺通气功能、六分钟步行试验距离、肺部并发症、肺康复不良事件发生率的差异。结果 术后1周、术后1月,试验组的第1秒用力呼气容积占预计值百分比、用力肺活量占预计值百分比、肺活量占预计值百分比、六分钟步行试验距离均高于对照组,差异均具有统计学意义(P<0.05)。术后1周,两组肺部并发症发生率比较,差异具有统计学意义(χ^(2)=40.069,P<0.001);术后1月,两组均无肺部并发症发生。两组在肺康复中均未发生跌倒、急性运动损伤、心血管不良事件等。结论 重度脊柱侧凸患者围手术期肺康复方案有利于提高患者术后肺通气功能及短期活动能力,降低肺部并发症发生率。未来可进一步延长随访时间,明确重度脊柱侧凸围手术期肺康复方案在术后患者的肺功能变化的长期效果。
Objective To establish a pulmonary rehabilitation program for patients with severe scoliosis during perioperative period,and to discuss its clinical effect.Methods Literature analysis and expert consultation were used to construct the perioperative pulmonary rehabilitation program for patients with severe scoliosis.A total of 28 patients with severe scoliosis admitted from July 2021 to October 2022 to a tertiary Grade-A hospital in Hangzhou were selected as the experimental group and 30 patients with severe scoliosis admitted from January 2020 to June 2021 as the control group by convenient sampling method.The experimental group received perioperative pulmonary rehabilitation program for patients with severe scoliosis on the basis of routine nursing,and the control group received routine nursing.The differences of pulmonary ventilation function,6-minute walking test distance,and incidence of pulmonary complications between the two groups were compared.Results One week after surgery and one month after surgery,the percentage of forced expiratory volume in onet second of the predicted value,the percentage of forced vital capacity in the predicted value,the percentage of vital capacity in the predicted value and the 6-minute walking distance of the experimental group were higher than those of the control group,the differences were statistically significant(P<0.05).One week after surgery,the incidence of pulmonary complications was statistically different between the two groups(χ^(2)=40.069,P<0.001).One month after surgery,no pulmonary complications occurred in both groups.No fall,acute motor injury or cardiovascular adverse events occurred in the two groups during pulmonary rehabilitation.Conclusion Perioperative pulmonary rehabilitation is beneficial to improve postoperative pulmonary ventilation function and short-term activity ability in patients with severe scoliosis,and reduce the incidence of pulmonary complications.In the future,follow-up time can be further extended to determine the long-term effect of perioperative pulmonary rehabilitation programonpostoperative lung function changes in patients with severe scoliosis.
作者
马姚静
余群飞
王鑫鑫
任英
许国萍
袁喆
MA Yaojing;YU Qunfei;WANG Xinxin;REN Ying;XU Guoping;YUAN Zhe(Department of Orthopaedics,The Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou,310009,China)
出处
《中华急危重症护理杂志》
CSCD
2023年第6期485-492,共8页
Chinese Journal of Emergency and Critical Care Nursing
基金
浙江省医药卫生科技计划(2023KY764)
浙江省医药卫生科技计划(2023KY738)
浙江省医药卫生科技计划(2019KY403)。
关键词
脊柱侧凸
肺康复
呼吸锻炼
肺通气
围手术期护理
Scoliosis
Pulmonary Rehabilitation
Breathing Exercises
P Iulmonary Ventilation
Perioperative Nursing
