冠状动脉搭桥术后物理治疗技术有效性的测定

İrem Hüzmeli̇, Nihan Katayıfçı, I. Fansa, Bircan Yucekaya, E. Timurtaş, M. Polat
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摘要

目的:探讨激励性肺活量计对冠脉搭桥术后呼吸肌力量、运动能力及血流动力学反应的影响。方法:在2017年6月至2018年12月期间,共有35例接受CABG手术的患者被纳入这项前瞻性随机对照研究。患者分为激励肺活量计(IS)组和物理治疗(PT)组。所有患者术后均接受标准物理治疗。此外,IS组还获得了容积型激励肺活量计。术后第2、5天呼吸肌力量(口压仪),运动能力(6分钟)。术后第3天进行步行试验(6-MWT),术后第1天进行物理治疗前和治疗后立即进行血气测定。结果:两组患者人口学特征相似。两组患者最大吸气压力(MIP)、最大呼气压力(MEP)、%MIP和%MEP值均有统计学意义(p 0.05)。PT组与IS组6个MWT参数比较,差异均无统计学意义(p > 0.05)。两组术后第1天动脉血气值比较,差异无统计学意义(p > 0.05)。结论:两组患者呼吸肌力均有改善,血气值维持正常。在CABG术后,IS联合PT在增加呼吸肌力量和维持动脉血气结果方面没有优势。从心脏手术后早期开始,IS联合物理治疗可以安全使用。
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Determination of the Effectiveness of Physiotherapy Techniques after Coronary Artery Bypass Graft Surgery
Objective: The aim of this study was to investigate the effects of incentive spirometer on respiratory muscle strength, exercise capacity and hemodynamic responses after CABG surgery. Methods: Between June 2017 and December 2018, a total of 35 patients underwent CABG surgery were included this prospective randomized controlled study. Patients divided into incentive spirometer (IS) group and physiotherapy (PT) group. All patients received standard physiotherapy postoperatively. In addition, IS group received volume-oriented incentive spirometer. Respiratory muscle strength (mouth pressure device) on 2nd and 5th postoperative day, exercise capacity (6-min.walking test (6-MWT)) on 3rd postoperative day, before and immediately after physiotherapy on the first post-operative day blood gases were assessed. Results: Demographic characteristics of the groups were similar in both groups. Statistically significant increases in maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), %MIP and %MEP values were observed in both two groups (p<0.05) but there was no statistically significant difference between the groups (p > 0.05). There were no significant differences in 6 MWT parameters between PT and IS group (p > 0.05). No significant difference was found in arterial blood gas values on first postoperative day in both groups (p > 0.05). Conclusion: Respiratory muscle strength improved and blood gas values maintained in both groups. There was no superiority of IS combined with PT in increasing respiratory muscle strength and in maintaining arterial blood gas results after CABG surgery. IS combined with physiotherapy could be used safely from the early period after cardiac surgery.
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