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目的　探讨激励性肺活量计 (IS)在预防腹部手术后肺部并发症中的作用。方法　对 1999～ 2 0 0 2年收治的 3 0 2例腹部手术病人进行前瞻性研究。将病人根据性别、年龄、手术部位等随机分为两组 ,实验组从术前3d开始使用激励性肺活量计持续至术后 3d ,比较两组腹部手术后肺部并发症的发生率。结果　 3 0 2例病人中有3 8例术后出现了手术后肺部并发症 (PPC) ,发生率为 12 58% ,上腹部手术为 14 2 9% ,下腹部手术为 5 2 6%。术前年龄 >60岁、有吸烟史、肺功能异常的病人术后PPC的发生率明显增高 ,分别为 17 16%、2 0 2 5%、2 0 59%。在观察组上腹部手术PPC的发生率有所降低 ,但差异无显著性。而对高龄、吸烟、原有肺部疾病的病人 ,使用激励性肺活量计后PPC的发生率明显降低 ,差异有显著性。结论　使用IS可降低上腹部手术PPC的发生率 ,尤其是对那些高龄、吸烟、原有肺部疾病的高危险因素病人 ,应用IS预防PPC更具有十分重要的意义

Clinical study on postoperative pulmonary complication after abdominal surgical Operation

ObjectiveTo study the incentive spirometry (IS) in prevent ing postoper ative pulmonary complications (PPC).MethodsThe data of 302 patients ex periencing abdominal operations collected from 1999 to 2002 in our department we re studied. P atients were assigned randomly into two groups according to gender, age and oper ation sites. In treatment group, IS was used from the 3rd day before operation to the 3rd after operation. The incidences of postoperative pulmonary complicat ions wer e compared.ResultsThirty-eight out of 302 had PPC, the incide nce being 12 58%. In upper abdo minal operations, the incidence was 14 29% and in lower abdominal operat io ns,the incidence was 5 26%. The incidence of PPC was significantly increased in patients with age over 60, smoking history , abnormal pulmonary function,being 17 16%, 20 25% and 20 59%, respective ly. In tr eatment group, the PPC incidence of upper abdominal operations was lower, but th ere was no statistical significance. While IS treatment significantly reduced th e PPC occurrence in patients with advanced age, smoking and original pulmonary dise ases. ConclusionIS can reduce PPC in upper abdomin al operations. Fo r those high-risk patients with advanced age, smoking history and original pulm onary diseases, the application of IS is of much importance in preventing PPC.