呼吸操锻炼对小儿脊柱侧弯术前肺功能的影响

背景小儿脊柱侧弯患者术后易发生急性呼吸功能不全的危险,术前进行综合呼吸操锻炼对其预防的效果尚未确定.目的探讨呼吸操锻炼对小儿脊柱侧弯患者术前应用的可行性和有效性.设计非随机横断面研究.地点、对象和方法选择上海长海医院对35例脊柱侧弯且肺功能障碍9～15岁住院患儿.术前1周对脊柱侧弯患儿实施组合的呼吸操训练,其内容包括缩唇呼吸、腹部运动呼吸、膈肌呼吸、吹气球.同时记录观察比较锻炼前后肺功能的变化.主要观察指标呼吸操锻炼前后患儿肺活量、肺容量、用力肺活量(forcedventilation capacity,FVC)、最大通气量(maximal ventilation volume,MVV)的变化.结果锻炼后患儿肺功能检查各项指标[肺活量,肺容量,FVC,MVV分别为(2.65±0.29),(3.56±0.79),(2.41±0.41),(70.1±17.0)L]比锻炼前[(1.77±0.36),(2.67±0.84),(2.07±0.46),(52.5±14.0)L]明显改善(t=3.64～11.28.P<0.01).结论术前进行呼吸操锻炼能改善患儿肺功能,提高对脊柱矫形手术的耐受力,对预防和减少术后呼吸功能不全的发生有积极作用.

Effects of breathing exercise on preoperative pulmonary function in adolescent scoliosis patients

BACKGROUND: Acute respiratory insufficiency is common complication of surgical treatment of adolescent scoliosis patients. The preventive effects of breathing exercise before surgery is still uncertain.OBJECTIVE: To explore the feasibility and efficacy of breathing exercises for scoliosis patients before operation.DESIGN: Nonrandomized cross sectional study.SETTING, PARTICIPANTS and METHODS: Totally 35 hospitalized kids with scoliosis and pulmonary dysfunction aged from 9 to 15 years old were selected from Shanghai Changhai Hospital. A set of breathing exercise including which included pursed lip breathing, abdominal breathing, diaphragmatic breathing and blowing balloon was performed to these patients one week before surgery. The changes of pulmonary function were recorded and compared before and after exercises.MAIN OUTCOME MEASURES: The change of vital capacity, lung capacity, forced ventilation capacity(FVC), maximal ventilation volume(MVV) before and after breath exercises.RESULTS: All sorts of indes are improved comparing with those before exercises. The vital capacity, lung capacity, FVC and MVV were greatly improved from(1.77 ±0. 36), (2.67 ±0. 84), (2.07 ±0.46), (52.5 ± 14.0) L before exercises to(2.65 ±0. 29), (3.56 ±0.79), (2.41 ±0.41), (70. 1 ± 17.0) L respectively( t = 3.63 - 11.28, P < 0.01).CONCLUSION: Preoperative breathing exercises can improve the pulmonary functions of kids with scoliosis and improve their tolerance to surgery and prevent the postoperative respiratory insufficiency.