Effect Of Pre-rehabilitation Assisted By Respirator On Early Postoperative Recovery Of Obese Patients After Laparoscopic Cholecystectomy

Objective:To investigate the effect of pre-rehabilitation assisted by a breathing exerciser on early postoperative recovery of obese patients after laparoscopic cholecystectomy.Methods:Ninety obese patients undergoing elective laparoscopic cholecystectomy were selected,42 males and 48 females,BMI 28～35 kg/m²,ASA physical status I or II,were divided into three groups by random number table method:control group（group C）,pre-rehabilitation group（group P）,breathing trainer-assisted pre-rehabilitation group（group M）,30 patients in each group.Group C only received traditional preoperative education,group P implement pre-rehabilitation strategies two weeks before operation,and group M implemented breathing trainer-assisted pre-rehabilitation strategy two weeks before operation.FEV₁,FVC,and lung ultrasound score（LUS）were recorded 1 day before pre-rehabilitation exercise（T₀）,6hours after extubation（T₁）,and 7 days after extubation（T₃）.The 6-minute walk test（6MWT）was conducted and the 6-minute walk distance（6MWD）was recorded at T₀,3 days after anesthesia extubation（T₂）,and T₃.Total number of analgesic pump compressions,the number of effective analgesic pump compressions,and the number of rescue analgesia were also recorded within 24 hours after operation.Respiration recovery time after surgery,extubation time,PACU stay time,the time of first postoperative ambulation,and postoperative hospital stay were recorded.The occurrence of postoperative pulmonary complications（PPCs）such as hypoxemia（Sp O?≤92%）,atelectasis,and pulmonary infection were recorded within 7 days after operation.Results:Compared with T₀,FVC and FEV₁were significantly decreased,while LUS were significantly increased at T₁and T₃in groups C,P and M（P<0.05）,FVC,FEV₁,and 6MWD were significantly increased at T₃in groups P and M（P<0.05）,and LUS were significantly increased at T₃in groups C,P and M（P<0.05）.Compared with group C,FVC and FEV₁were significantly increased,while LUS were significantly decreased at T₁and T₃in groups P and M（P<0.05）,6MWD was significantly increased at T₃in groups P and M（P<0.05）,extubation time and PACU stay time were significantly shortened in groups P and M（P<0.05）,the time of first postoperative ambulation and postoperative hospital stay were shorterned in group M（P<0.05）,the incidence of postoperative hypoxemia were significantly lower in group M（P<0.05）.Compared with group P,FVC and FEV₁were significantly increased,while LUS were significantly decreased at T₁and T₃in group M（P<0.05）,the time of first postoperative ambulation and postoperative hospital stay were significantly shortened in group M（P<0.05）.Conclusion:Preoperative respiratory training device-assisted pre-rehabilitation measures can effectively improve the pulmonary condition in obese patients after laparoscopic cholecystectomy,enhance their exercise endurance level,reduce the incidence of hypoxemia,thus facilitating recovery after surgery.