The Application Research Of Preoperative Deep Respiratory Training Apparatus In Patients Undergoing Open Heart Surgery

Background and objectiveOpen heart surgery is characterized by large trauma,long operation time,the de-struction of the integrity of the thorax and prolonged use of ventilator after operation and so on.The anesthesia endotracheal intubation and surgical procedures itself will also cause difterent degrees of injury and irritation to the bronchus,lobe,etc.These factors are likely to increase airway secretions in patients,resulting in postoperative pneumonia,pulmonary atelectasis and other pulmonary complications.Respiratory failure may even occu in severe cases.According to reports in the literature,the incidence of postoperative pulmonary complications after open heart surgery is as high as 5%to 25%.While in the cases of death in open heart surgery,the mortality rate is approximately 8%-24%due to pulmonary complications.In order to reduce the incidence of pulmonary complications after open heart surgery,effective respiratory training for patients before surgery has in-creasingly attracted the attention of clinicians.These methods include deep breathing,deep breathing cough,chest sniper and so on.In recent years.the deep respiratory training apparatus has gradually been applied to the clinic.And the feasibility of deep respiratory training apparatus for patients before open heart surgery has been studied in this center.This article which is based on the previous research intends to further explore the safety and effectiveness of preoperative deep respiratory training apparatus in patients undergo-ing open heart surgery.Method100 patients who underwent open heart surgery from January 2013 to December 2016 in the heart surgery department of the People’s Hospital of Northern Jiangsu were con-tinuously selected and were as the subject of this study.Our department has applied deep respiratory training apparatus to all patients undergoing open heart surges since 2015.Therefore,50 patients undergoing open heart surgery were continuously selected from January 2013 to December 2014 as control groups,and other 50 patients undergoing open heart surgery were continuously selected from January 2015 to December 2016 as inter-vention groups.Analyze and compare the incidence of postoperative pulmonary compli-cations,ventilator use time,ICU PO2 before extubation,ICU retention time,indwelling time of pericardial and mediastinal drainage tube,ECG monitoring time,length of hospi-tal stay and so on.Statistical analysis:Data analysis were completed with spss24.0 software.The meas-urement data was expressed by mean(x)±standard deviation(s).The independent data t-test is used for the comparison of intra-and intra-group comparisons of measurement data.The count data were compared with chi-square test,and the data were compared between groups.Comparison between groups of level data is analyzed by rank test,And P<0.05 was considered statistically significant.ResultThe clinical datas of all selected patients were successfully collected and analysed.There was no significant difference in the general data of age,height,weight,gender distribution,type of surgery,laboratory tests,and preoperative cardiacejection fraction between the two groups of patients.There were no postoperativeor hospital deaths in both groups.These parameters including the incidence of postoperative pulmonary complica-tions,ICU PO2 before extubation,ventilator use time.ICU retention time,ECG monitor-ing timer pericardial and mediastinal drainage tube indwelling time,length of hospital stav were statistically significant(P<0.05)between the intervention group and the control group,espectively,as follows:the incidence of pulmonary complications 10%VS26%;the ventilator use time 19.22±5.72(h)VS24.20±14.25(h);ICU PO2 before extuba-tion201.68±34.38(mmHg)VS186.12±39.76(mmHg);ICU retention time 26.30±11.44(h)VS33.78±12.42(h):ECG monitoring time3.82±0.92(day)VS4.26±1.58(day);indwelling time of pericardial drainage tube2.72±0.73(day)VS3.76±0.84(day):indwelling time of mediastinal drainage tube 2.76±0.66(day)VS3.64±0.63(dav):Iength of hospital stay 15.16±3.35(day)VS 17.50±4.89(day)Conclusions1.Preoperative use of deep breathing exercise training can reduce the incidence of post-operative pulmonary complications in patients undergoing open heart surgery,and re-duce drainage tube indwelling time,shorten the time of ECG monitoring and reduce the hospitalization days after surgery.2.Through the effective preoperative training of deep respiratory training apparatus,It can improve the patient’s lung ventilation and postoperative arterial blood oxygen tension,so that early extubation can be achieved in the ICU,thereby shortening the ICU indwelling time.