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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(forcedventilationcapacity,FVC)、最大通气量(maximalventilationvol-ume,MVV)的变化。结果:锻炼后患儿肺功能检查各项指标犤肺活量,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犦比锻炼前犤(1.77±0.36),(2.67±0.84),(2.07±0.46),(52.5±14.0)L犦明显改善(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。
BACKGROUND: Pediatric scoliosis patients are at high risk of developing acute respiratory insufficiency. The preventive effect of preoperative respiratory exercises has not been confirmed. Objective: To investigate the feasibility and effectiveness of respiratory exercises in the preoperative application of pediatric patients with scoliosis. Design: Non-random cross-sectional study. Location, object and method: 35 patients with scoliosis and pulmonary dysfunction aged 9-15 years were selected from Shanghai Changhai Hospital. One week before operation, a combination of breathing exercises training is performed on children with scoliosis. The contents include reduced-lip breathing, abdominal motion breathing, diaphragmatic breathing, and balloon blowing. At the same time observe the changes in lung function before and after exercise comparison. MAIN OUTCOME MEASURES: Changes in vital capacity, lung volume, forced vital capacity (FVC) and maximal venous volume (MVV) in children before and after breathing exercises. Results: The lung function, lung capacity, FVC and MVV were (2.65 ± 0.29), (3.56 ± 0.79), (2.41 ± 0.41), (70.1 ± 17.0), respectively (1.77 ± 0.36), (2.67 ± 0.84), (2.07 ± 0.46) and (52.5 ± 14.0) L 犦 significantly improved (t = 3.64 ~ 11.28, P <0.01). Conclusion: Preoperative respiratory exercise can improve lung function in children and improve the tolerance to spinal surgery, which has a positive effect on preventing and reducing postoperative respiratory insufficiency.