長吐氣呼吸法對肺葉切除術後病人心肺功能之效果

The Effect of Enforced Expiratory Breathing on Cardio-pulmonary Function in Post-thoracotomy Patients

本研究以實驗方式比較平常呼吸、傳統深呼吸、及長吐氣呼吸時心肺功能的反應，以驗證長吐氣法對增加氧合與通氣的效果，並評估長吐氣呼吸法臨床之應用性。計有69位無肺疾年輕個案及31位接受肺葉切除術個案志願加入本研究。無肺疾個案在學習長吐氣呼吸法之當天接受三種呼吸時血氧飽合度(SpO2)、吐氣末二氧化碳分壓(EtCO2)、心跳率、血壓、末稍體表溫度等心肺功能反應的測量；肺疾個案在術前1~2天接受長吐氣呼吸法之指導，並分別於術前一天、術後第3天、術後第5天接受測量，術後的測量並包括呼吸時的疼痛感。研究結果顯示正常人長吐氣法促進換氣的效果不亞於傳統深呼吸；而在胸腔手術病患，長吐氣法的換氣促進效果則優於傳統深呼吸。在心血管系統的反應上，長吐氣呼吸法使收縮壓、舒張壓下降，末稍體表溫度上升，顯示長吐氣呼吸法不會增加心血管系統之壓力，而是具有穩定心血管系統功能的效果；長吐氣呼吸法引起胸擴的活動較小，較不疼痛。因此，在胸腔手術病患的護理上，可以考慮以長吐氣呼吸法取代傳統的深呼吸，以促進病患之術後恢復與復健。

The purpose of this study was to investigate the effect of enforced expiratory breathing on improving oxygenation and ventilation. 69 normal subjects and 31 patients receiving lobectomy surgery were enrolled voluntarily into this study. The measures included SpO2, EtCO2, HR, SBP, DBP, and finger temperature during normal breathing, deep breathing (DB), and enforced expiratory breathing(EEB). Normal subjects were measured on the day learning enforced expiratory breathing. Lobectomy patients were measured on the eve of surgery and the 3rd day and 5th day after surgery. The data indicated that the effect of EEB on improving ventilation was as good as DB in normal subjects, and was better than DB in lobectomy patients. In conducting EEB, the subjects demonstrated significant reductions in SBP and DBP, and elevations on finger temperature, indicating that EEB has stabilizing effect on the cardiovascular system. All the lobectomy subjects marked less score on pain scale in conducting EEB than DB. The results of this study demonstrated that EEB may be a valuable alternative breathing method for patients receiving chest surgery.