■具体的外科手术,例如上腹部和胸外科手术,与术后肺部并发症(PPC)的易感性增加有关。在上腹部手术中,PPC的发生率可能在20-90%之间变化。可以通过使用增加肺活量和鼓励灵感的治疗程序来最小化。这篇综述旨在研究促进肺扩张的现有循证干预措施的有效性。从而防止PPC。
■我们主要集中于术前教育对激励肺活量计的现有证据,早期动员,定向咳嗽,深呼吸练习,胸部理疗,和吸气肌训练(IMT)以防止PPC。文献检索仅限于实验,观察性研究,系统审查,以及过去15年发表的文章,2007年1月-12月2022年,在PubMed和GoogleScholar中。
■此初始搜索共产生5301篇文章。所有标题与主题无关的文章都被删除。1050条记录被筛选,最后审查了22篇文章,包括13项随机对照试验(RCT),四个系统审查,一次回顾性审查,三项观察性研究,和一项非实验性研究。我们的审查揭示了个人干预的混合证据,包括但不限于激励肺活量测定,吸气肌训练,早期动员,咳嗽,深呼吸,等。一些研究认为干预是有效的;另一些研究则暗示干预的选择没有实质性差异。
■文献综述得出的结论是,接受多种干预的患者术后肺功能明显改善。然而,需要进行明确的研究来巩固这一结论。
UNASSIGNED: Specific surgical procedures, such as upper abdominal and thoracic surgery, are connected to an increased predisposition of postoperative pulmonary complications (PPCs). The incidence of PPCs could vary approximately between 20-90% with upper abdominal surgery, which can be minimized by using treatment procedures that increase lung capacity and encourage inspiration. This review aims to examine the effectiveness of already existing evidence-based interventions that promote lung expansion, thereby preventing PPCs.
UNASSIGNED: We mainly focused on the existing evidence of preoperative education on the incentive spirometer, early mobilization, directed coughing, deep breathing exercises, chest physiotherapy, and inspiratory muscle training (IMT) to prevent PPCs. The literature search was limited to experimental, observational studies, systemic reviews, and articles published in the last 15 years, January 2007- Dec. 2022, in PubMed and Google Scholar.
UNASSIGNED: This initial search yielded a total of 5301 articles. All articles with titles not related to the topic were eliminated. 1050 records were screened, and the final review was conducted with 22 articles, including 13 randomized controlled trials (RCTs), four systemic reviews, one retrospective review, three observational studies, and one non-experimental study. Our review reveals mixed evidence for individual interventions, including but not limited to incentive spirometry, inspiratory muscle training, early mobilization, cough, deep breathing, etc. Some studies maintain that intervention is effective; others imply there is no substantial difference in the choice of intervention.
UNASSIGNED: The literature review concluded that patients who received multiple interventions showed significant improvement in pulmonary function postoperatively. However, definitive studies need to be conducted to solidify this conclusion.