Application of accelerated pulmonary rehabilitation measures in perioperative treatment of lung contusion complicated with multiple rib fractures

Xiang Minfeng; Qi Fenqiang; Wei Fuwang; Jiang Qingbai

doi:10.3760/j.issn.1673-4777.2019.11.011

Abstract：Objective To discuss the value of accelerated pulmonary rehabilitation measures in perioperative treatment of lung contusion complicated with multiple rib fractures.Methods A total of 92 patients with lung contusion and multiple rib fractures were enrolled from January 2014 to December 2018 in Liuzhou Workers Hospital,Guangxi Zhuang Autonomous Region.They were randomly divided into observation group and control group,with 46 cases in each group.The observation group was treated with standardized and systematic measures to accelerate pulmonary rehabilitation during perioperative period,focusing on physical rehabilitation measures such as early ambulation,blowing balloon and climbing stairs.The control group had routine perioperative treatment.Blood gas,pulmonary function indexes,pulmonary complications,hospital stay time and medical expenses were analyzed.Results Arterial partial pressure of oxygen and arterial oxygen saturation in observation group were significantly higher than those in control group on the first day after operation [(80 ±t 28) mmHg vs (73±9)mmHg,(96±5)％ vs (94±4)％](t =2.472,P=0.046;t=2.468,P=0.043);there were no significant differences in pH value and arterial partial pressure of carbon dioxide between groups (all P ＞ 0.05).One week after operation,the peak expiratory flow in observation group was significantly higher than that in control group[(4.3 ±2.0)L/s vs (3.9 ± 1.5) L/s] (P ＜0.05);there was no significant difference of forced expiratory volume in 1 second between groups (P ＞ 0.05).Incidences of pulmonary infection,atelectasis and mechanical ventilation 48 hours after operation in observation group were significantly lower than those in control group(all P ＜ 0.05).Conclusion Accelerated pulmonary rehabilitation measures can improve pulmonary function,reduce complications and promote recovery in patients with lung contusion and multiple rib fractures.