主动循环呼吸训练应用于老年肺癌术后患者的效果

目的:探讨主动循环呼吸训练促进老年肺癌术后患者肺功能恢复及降低肺部并发症中的应用价值.方法:按照随机数字表法将105例老年肺癌术后患者分为对照组52例和观察组53例.对照组给予围术期管理和反馈式呼吸刺激,观察组在此基础上增加主动循环呼吸训练,对比两组肺功能、血气指标及并发症发生情况.结果:观察组训练2周后最大肺活量、用...     

老年肺癌手术患者主动循环呼吸技术训练自信心培养的效果评价

目的 探讨老年肺癌手术患者主动循环呼吸技术训练自信心培养对肺康复效果的影响。 方法 选择2016年9月—12月35例老年肺癌手术患者为对照组并接受胸外科常规呼吸训练,选择2017年1月—4月35例老年肺癌手术患者为试验组,在常规护理的基础上,接受主动循环呼吸技术训练自信心培养干预。比较两组术后前3d 的排痰量、肺部并发症及干预前后呼气峰流速、 6 分钟步行试验、运动自我效能的情况。 结果 试验组术后第 2 天、第 3 天的排痰量高于对照组,呼气峰流速、6分钟步行试验结果改善,运动自我效能明显提高,两组差异有统计学意义（P<0.05）。两组术后肺部并发症发生率差异无统计学意义（P>0.05）。结论 主动循环呼吸技术训练自信心培养对老年肺癌患者是一种简便、有效、易行的短期肺康复方法。     

主动呼吸训练联合肺功能康复训练对老年肺癌患者行胸腔镜术后肺功能及肺部感染的影响

目的探讨主动呼吸训练联合肺功能康复训练对老年肺癌患者行胸腔镜术后肺功能及肺部感染的影响。方法选取行胸腔镜手术的老年肺癌患者135例,按随机数字表法分为2组:对照组67例予以肺功能康复训练,研究组68例予以主动呼吸训练联合肺功能康复训练。比较2组肺功能指标[用力肺活量(FVC)、第1秒用力呼吸量(FEV1)、第1秒用力呼吸量与用力肺活量的比值(FEV1/FVC)、最大通气量(MVV)、呼吸频率(RR)]、血气指标[动脉血氧分压(PaO 2)、动脉血二氧化碳分压(PaCO 2)]及肺部感染率。结果干预前2组FVC、FEV1、FEV1/FVC、MVV、RR比较,差异无统计学意义(P>0.05);与干预前比较,2组干预后FVC、FEV1、FEV1/FVC、MVV均显著升高,RR均显著减慢,差异均有统计学意义(均P<0.05);与对照组比较,研究组干预后FVC、FEV1、FEV1/FVC、MVV均显著升高,RR显著减慢,差异均有统计学意义(P<0.05)。干预前2组PaO 2、PaCO 2比较,差异无统计学意义(P>0.05);与干预前比较,2组干预后PaO 2均显著升高,PaCO 2均显著降低,差异均有统计学意义(均P<0.05);与对照组比较,研究组干预后PaO 2显著升高,PaCO 2显著降低,差异均有统计学意义(均P<0.001)。与对照组比较,研究组干预后肺部感染率显著降低,差异有统计学意义(χ2=4.353,P=0.037)。结论主动呼吸训练联合肺功能康复训练应用于老年肺癌患者行胸腔镜术后可增强患者肺功能、改善血气指标、降低肺部感染发生率。     

基于健康信念模式的护理策略联合呼吸康复训练对肺癌术后化疗患者预后的影响

目的 探讨基于健康信念模式的护理策略联合呼吸康复训练对肺癌术后化疗患者预后的影响。方法 2018年3月-2020年3月南京市胸科医院收治的肺癌术后化疗患者84例,随机分为对照组42例和观察组42例。对照组实施呼吸康复训练干预,观察组在对照组的基础上实施健康信念模式的护理策略。干预前后比较两组患者焦虑情况、肺功能指标和并发症的发生情况。结果 干预后观察组SAS评分明显低于对照组,差异有统计学意义(P<0.05)。观察组肺功能指标明显高于对照组,并且并发症发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论 对肺癌术后化疗患者实施健康信念模式联合呼吸康复训练的护理策略,可以取得满意的护理效果,有利于提高预后。     

主动循环呼吸技术训练联合自信心培养对老年肺癌手术病人肺康复效果的影响

[目的]探讨主动循环呼吸技术训练联合自信心培养对老年肺癌手术病人肺康复效果的影响。[方法]选择140例于2018年5月—2019年4月在某院明确诊断为肺癌并准备行手术治疗的老年肺癌手术病人,并将其分成对照组与观察组,各70例。对照组(入院时间为2018年5月—2018年10月)开展胸外科常规呼吸训练,观察组(入院时间为2018年11月—2019年4月)开展主动循环呼吸技术训练联合自信心培养。比较两组病人术后前3 d的排痰量、肺部并发症以及干预前后中文版运动自我效能量表(Self-Efficacy for Exercise Scale,SEES-C)评分、6 min步行试验(6 MWT)、呼气峰流速状况。[结果]两组病人术后第1天排痰量比较差异无统计学意义(P0.05),观察组病人术后第2天、第3天排痰量多于对照组,差异有统计学意义(P0.05)。对照组发生肺部并发症12例,观察组5例,两组比较差异无统计学意义(P0.05)。两组病人干预前SEES-C评分、6 MWT、呼气峰流速比较差异无统计学意义(P0.05),干预后观察组病人SEES-C评分、6 MWT、呼气峰流速高于对照组,差异有统计学意义(P0.05)。[结论]对老年肺癌病人实施主动循环呼吸技术训练联合自信心培养,不但有助于肺康复,而且简单易实现,效果突出。     

多元化呼吸训练指导对胸腔镜肺叶切除术患者术后肺部并发症的影响

目的探讨多元化呼吸训练指导对胸腔镜肺叶切除术患者术后肺部并发症的影响。方法选取收治的行胸腔镜肺叶切除术患者86例,采用随机数字表法分为对照组和观察组各43例,对照组术后采用常规护理干预,观察组术后采用多元化呼吸训练指导干预,对比两组肺功能指标与肺部并发症发生情况。结果干预2个月后,观察组肺活量(VC)、第1秒用力呼气量(FEV1)、第1秒用力呼气量占用力肺活量比率(FEV1/FVC)等肺功能指标均高于对照组,肺部并发症发生率低于对照组,差异具有统计学意义(P<0.05)。结论胸腔镜肺叶切除术患者术后施行多元化呼吸训练指导,利于改善患者肺功能,减少肺部并发症,安全高效,促进患者康复,值得临床广泛应用。     

呼吸功能锻炼器在冠状动脉搭桥术后的应用效果观察

[目的]探讨应用呼吸功能锻炼器对冠状动脉搭桥手术后病人肺功能、肺部并发症及生存质量的影响。[方法]回顾性分析我科2009年1月—2011年1月67例住院行冠状动脉搭桥术病人,对照组给予常规的呼吸训练,试验组除给予常规呼吸训练外,还采用呼吸功能锻炼器进行训练,观察两组肺功能及生活质量改善情况。[结果]经呼吸功能锻炼后试验组病人呼吸功能、肺活量及生存质量均显著提高,与对照组相比,差异具有统计学意义(P<0.05);且两组肺部并发症发生率比较差异也有统计学意义(P<0.05)。[结论]冠状动脉搭桥术后病人使用呼吸功能锻炼器,可改善肺功能、减少肺部并发症、提高病人生存质量。     

呼吸训练对肺癌患者术后肺功能和生活质量的影响

目的:探讨呼吸训练对肺癌患者术后肺功能和生活质量的影响。方法:将135例肺癌手术患者按入院先后顺序随机分为对照组68例和观察组67例,对照组按常规胸部手术护理标准完成围术期护理,包括体位变化、生命体征指标观察、呼吸道管理、疼痛护理、心理护理等,观察组在对照组基础上给予呼吸训练。比较两组患者肺功能指标及生活质量评分。结果:观察组患者术后肺功能指标优于对照组术后,两组比较差异有统计学意义(P0.05);观察组患者术后生活质量评分高于对照组,两组比较差异有统计学意义(P0.05)。结论:呼吸训练能有效改善肺癌术后患者肺功能指标,提高其生活质量,值得临床推广。     

主动呼吸循环技术联合回馈教学对肺癌手术患者快速康复的影响

目的观察主动呼吸循环技术联合回馈教学对肺癌手术患者快速康复的影响。方法将100例患者按照手术时间分为对照组(50例)和观察组(50例),对照组采用胸外科常规呼吸功能锻炼,观察组采用主动呼吸循环技术联合回馈教学进行呼吸功能锻炼。比较两组患者肺部并发症发生率、6 min步行试验距离、胸腔闭式引流管留置时间及术后住院时间。结果观察组患者肺部并发症发生率、胸腔闭式引流管留置时间及术后住院时间均低于对照组,6 min步行试验距离大于对照组,比较差异均有统计学意义(P0.05)。结论主动呼吸循环技术联合回馈教学法可以有效减少肺癌手术患者肺部并发症的发生,提高患者的运动耐量,加快患者康复。     

围手术期强化呼吸功能训练在食管癌患者中的应用效果评价

目的：探讨实施围手术期强化呼吸功能训练在食管癌患者中的应用效果。方法将需行食管癌根治手术的84例患者随机分为观察组（42例）和对照组（42例）,对照组给予常规呼吸功能训练,观察组实施围手术期强化呼吸功能训练方案。比较两组患者术后心率、呼吸频率、动脉血氧饱和度、肺功能及肺部并发症的发生情况。结果观察组术后心率、呼吸频率、动脉血氧饱和度、肺功能等相关指标均优于对照组,差异有统计学意义（P<0.05）;观察组肺部并发症的发生率低于对照组,差异有统计学意义（P<0.05）。结论实施围手术期强化呼吸功能训练方案可以有效改善患者的呼吸功能,促进术后病体康复,减少术后并发症的发生。     

Suppression of spontaneous breathing during high-frequency jet ventilation

The effect of ventilatory frequency of high-frequency jet ventilation (HFJV) from 1 to 5 Hz, apart from changes in thoracic volume, on spontaneous breathing activity was studied in Yorkshire piglets under pentobarbital anesthesia. The highest P_aCO₂ at which the animals did not breathe against the ventilator (apnea point) was established either by changing minute volume of ventilation or by adding CO₂ to the respiratory gas. The higher the apnea point, the higher the suppression of spontaneous breathing activity was assumed to be. If the apnea point was searched for by changing minute volume a progressive increase of suppression of spontaneous respiratory activity was found at ventilatory rates of 3 Hz or more, concomitantly with a rise in end-expiratory pressure (P_EE). In case the tidal volume was kept constant, increase of ventilatory rate resulted in a tremendous increase of lung volume, together with considerably higher levels of P_EE. When under these conditions the apnea point was searched for by adding CO₂ to the respiratory gas a much higher CO₂-drive was needed for spontaneous breathing and therefore a much stronger inhibition of spontaneous breathing was concluded. By placing the animals in a body box in which pressure could be varied, thoracic volume could be kept constant during HFJV. When thoracic volume was kept constant in this way a constant tidal volume at increasing jet frequencies resulted in only a slight increase in suppression of spontaneous breathing.We conclude that the increase in lung volume is a major factor in suppressing central respiratory activity during HFJV. Jet frequency by itself might be an additional suppressive factor. Airway CO₂ did not seem to have an important effect.     

肺癌患者术前呼吸训练管理的最佳证据总结

目的检索和分析肺癌患者术前呼吸训练的相关证据,并对最佳证据进行总结,为临床医护人员对肺癌患者术前呼吸训练的管理提供参考。方法计算机检索UpToDate、Cochrane Library、PubMed等数据库中关于肺癌患者术前呼吸训练的所有证据,包括指南、专家共识、证据总结、系统评价及与证据密切相关的原始研究。检索时间为建库至2019年2月1日。结果共纳入证据8篇,包括临床决策1篇,指南1篇,专家共识3篇,系统评价2篇,原始研究1篇。肺癌患者术前呼吸训练的证据主要为呼吸训练的方法、强度及频率等。结论所有纳入研究的证据均显示肺癌患者术前呼吸训练是有益的,医护人员应基于循证及临床情境制定合理的呼吸训练方案,以使肺癌患者术前的呼吸训练管理更科学、有效。     

Suppression of spontaneous breathing during high-frequency jet ventilation

Conditions which suppress spontaneous breathing activity during high-frequency jet ventilation (HFJV) were analysed in Yorkshire piglets under pentobarbital anesthesia. The highest P_aCO₂ at which the animals did not breathe against the ventilator (apnea point) was established during different patterns of ventilation, either by changing the minute volume or by adding CO₂ to the inspiratory gas. Arterial oxygen tension was maintained throughout the study above 80 mm Hg. An elevation of ventilatory rate increased the apnea point, suggesting a progressive suppression of spontaneous breathing. This suppression did not depend on the amount of lung stretch during insufflation, because at higher rates lower tidal volumes were used. Suppression also appeared to be independent of insufflatory flow, i.e. the velocity of lung stretch. At higher frequencies end-expiratory airway pressure (P_EE) increased and there appeared to be a positive relationship between the apnea point and P_EE. In a separate series this positive relationship between the apnea point and P_EE was confirmed. A hysteresis effect in this relationship, however, suggests that other than jet frequency, lung volume rather than positive end-expiratory pressure (PEEP) is a major determinant of suppression of spontaneous breathing activity during HFJV.     

慢性阻塞性肺疾病患者振动反应呼吸成像检查的护理

目的 探讨对慢性阻塞性肺疾病(COPD)患者进行振动反应呼吸成像(VRI)检查的护理.方法 对255例COPD患者进行了VRI检查,从检查前的准备,操作中的护理,防治院内感染等方面,观察了检查的完成情况.结果 VRI是一项全新的动态肺部功能检查,病人容易产生恐惧、紧张的心理,从而影响检查的结果.细致的心理护理,检查中熟练的操作和恰当的呼吸指导,可以消除患者的紧张情绪,保证检查的顺利完成.结论 心理护理和正确的呼吸指导对VRI检查的顺利完成具有重要价值.     

Intermittent positive-pressure breathing effects in patients with high spinal cord injury

Laffont I, Bensmail D, Lortat-Jacob S, Falaize L, Hutin C, Le Bomin E, Ruquet M, Denys P, Lofaso F. Intermittent positive-pressure breathing effects in patients with high spinal cord injury.

Objective

To determine whether intermittent positive-pressure breathing (IPPB) improved lung compliance, work of breathing, and respiratory function in patients with recent high spinal cord injury (SCI).

Design

An unblinded randomized crossover trial.

Setting

Rehabilitation hospital.

Participants

Patients (N=14) with SCI caused by trauma within the last 6 months and located between C5 and T6.

Intervention

Two months of IPPB and 2 months of conventional treatment were evaluated prospectively in random order in patients with SCI.

Main Outcome Measures

Noninvasive lung function tests and arterial blood gas measurements were obtained repeatedly in all patients. Repeated measurements of dynamic lung compliance and work of breathing as measured by computing the area enclosed between the inspiratory esophageal pressure-tidal volume curve, and the theoretical chest wall static pressure-volume curve were performed in 7 patients.

Results

IPPB had no long-term effects on vital capacity (52.1%±11.3% vs 54.5%±12.5%, after conventional treatment and IPPB, respectively; P=.27), lung compliance (66.4±48.9mL/cmH₂O vs 70.3±38.4mL/cmH₂O; P=.56), or other lung function tests. IPPB did not exert short-term effects on lung compliance or work of breathing.

Conclusions

IPPB produced no immediate or long-term improvements in lung function or ventilatory mechanics in patients with recent SCI. (ClinicalTrials.gov identifier: NCT00476866.)     

重度肥胖对肺功能及运动试验中呼吸模式的影响

目的：研究重度肥胖对肺胖对肺功能及运动试验中呼吸模式的影响。方法：４２名女性受试者,正常体重组２０名,重度肥胖组２２名,进行肺功能及功率车运动试验测定。结果：肥胖组补呼气量、功能残气量、残气量及肺总量均比对照组显著降低（Ｐ〈０．０５）。肥胖组静息状态、无氧阈状态和极量运动状态的氧耗量均比对照组显著增高（Ｐ〈０．０５）,而公斤氧耗量比对照组显著降低（Ｐ〈０．０１）。无氧阈状态和极量运动状态时,肥胖组     

自我效能干预联合反馈式呼吸训练对肺癌放疗后患者肺功能与癌因性疲乏的影响

目的探讨自我效能干预联合反馈式呼吸训练对肺癌放疗后患者肺功能与癌因性疲乏的影响。方法选择我院2017年3月至2019年3月收治的肺癌放疗后患者90例,将其随机等分成对照组和观察组,对照组行常规护理,观察组行自我效能干预联合反馈式呼吸训练,比较两组患者肺功能与癌因性疲乏情况。结果观察组FEV 1、FEV 1/FVC及6 min步行距离均高于对照组(P<0.05),癌因性疲乏量表各维度评分均低于对照组(P<0.05)。结论自我效能干预联合反馈式呼吸训练在肺癌放疗后患者中应用,能显著改善其肺功能,缓解癌因性疲乏。     

Noninvasive pulmonary function screening in spontaneously breathing rodents: an engineering systems perspective

Noninvasive pulmonary function measurements made on rodents are commonly used for studies where quick, relatively easy end-points are required. These types of measurements are of particular advantage for studies where large numbers of animals are involved. Using tests that are simple to administer generally translates to more efficient and more accurate data collection. Noninvasive measurements result in less stress placed on the animal and allow repeated testing of the same animals at multiple time points. This review focuses on several noninvasive methods that have been developed for pulmonary function screening, which are analyzed from an engineering systems perspective. An analog model of the respiratory system of a conscious, freely respiring animal is presented in terms of an equivalent electrical circuit. This model is used as a basis to demonstrate the relationship between pulmonary parameters derived from circuit analysis.     

肺康复训练对慢性阻塞性肺疾病稳定期患者的疗效观察

目的:观察慢性阻塞性肺疾病(COPD)进行肺康复训练的效果。方法:COPD稳定期患者78例随机分为观察组和对照组各39例,2组都给予常规药物对症支持治疗,对照组在治疗期间给予常规肺康复,观察组在对照组康复的基础上给予三球式呼吸训练器康复。结果:治疗3个月后,观察组临床控显率显著高于对照组(P0.05);2组的FEV1/FVC均显著高于治疗前(P0.05),且观察组高于对照组(P0.05);观察组治疗后的最大摄氧量(VO2max)、最大功率均显著高于治疗前及对照组(P0.05),对照组治疗前后差异无统计学意义;治疗后,观察组的圣乔治问卷(SGRQ)症状分、活动分、影响分与总分评分均显著低于对照组(P0.05)。结论:COPD稳定期患者应用三球式呼吸训练器进行肺康复训练可以改善患者肺功能与运动耐力,提高治疗效果,促进生活质量的改善,有很好的应用价值。     

深慢腹式阻力呼吸改善COPD患者肺功能的研究

用深慢腹式呼吸配合阻力呼吸的方法，对慢性阻塞性肺疾病患者进行呼吸训练，以提高患者呼吸肌的肌力和耐力，从而改善患者的肺功能。将５５例ＣＯＰＤ患者分为两组，治疗组３０例进行深慢腹式阻力呼吸锻炼，对照组２５例进行深慢腹式呼吸锻炼。６周后测定并对比锻炼前后肺功能指标（ＶＣ，ＴＶ，ＴＬＣ，ＦＥＶ_１％，ＦＶＣ％，ＰＥＦＲ，ＲＶ，ＦＲＣ，ＲＶ／了ＬＣ％，Ｖ_（５０）／ＨＴ，Ｖ_（２５）／ＨＴ，Ｖ_（５０）／Ｖ_（２５）），治疗组的ＶＣ，ＦＶＣ％，ＰＥＦＲ，ＲＶ，ＲＶ／ＴＬＣ％有显著改善（Ｐ＞０．０５）。运动耐力亦有提高（可多上一层楼）。对照组无显著改善。