综合胸部物理治疗预防老年开胸术后肺不张的效果观察

目的 观察综合胸部物理治疗对老年开胸术后肺不张预防的效果.方法 将68例老年开胸患者随机分为2组,其中实验组35例采用综合胸部物理治疗,对照组33例采用常规胸部物理治疗,比较2组患者术后遵医行为、PaO2、PaCO2、SaO2改善差值、排痰效果、肺不张发生率.结果 实验组患者术后遵医行为和排痰效果均优于对照组,实验组PaO2、PaCO2、SaO2治疗后改善差值明显高于对照组（P〈0.05）;实验组肺不张发生率5.71%（2例）,对照组肺不张发生率27.27%（9例）,其差异有统计学意义（P〈0.05）.结论 老年开胸患者在围手术期全程适时采用综合胸部物理治疗比常规胸部物理治疗能提高患者术后遵医行为、促进痰液的排出,提高血氧分压,促进肺膨胀,更有效地预防老年开胸术后肺不张的发生.

Observation on efficacy of compositive chest physiotherapy for the prevention of atelectasis after thoracotomy in the elderly patients

Objective To investigate the clinical effect of compositive chest physiotherapy for the prevention of atelectasis after thoracotomy in the elderly patients.Methods Sixty-eight elderly patients after thoracotomy were randomly divided into two groups, the experimental group adopted compositive chest physiotherapy(n = 35), the control group were given the traditional chest physiotherapy(n = 33).The factors considered included the action abide by doctor,the effect of expectoration, the improvement difference of PaO2 ,PaCO2 , SaO2 by blood gas analysis, the incidence of atelectasis.Results There were significant differences in the action abide by doctor and the effect of expectoration. After intervention, the improvement difference of PaO2 ,PaCO2 and SaO2 were significant higher than that of the control group(P <0.05); The rates of atelectasis were 5.71% (2 cases) and 27.27% (9 cases) in experimental group and control group respectively (P < 0.05).Conclusions Compositive chest physiotherapy is superior to traditional physiotherapy for elderly patients in pedoperation, which can clear sputum more effectively, improve blood oxygen partial pressure and lung expansion, also can prevent pest-operative atelectasis more effectively in the elderly patients.