探讨肩关节操联合呼吸训练对主动脉夹层开胸术后患者呼吸功能康复的影响。

选取2019年1月至2020年12月在广州医科大学附属第一医院动脉夹层行开胸手术患者76例，按住院日期偶数为对照组，奇数为观察组各38例，对照组术后予常规护理，观察组术后在常规护理基础上，给予肩关节操及呼吸训练干预，比较两组患者术后血氧饱和度(SpO₂)、血乳酸水平(LAC)的变化。t检验、方差分析和卡方检验用于数据分析。

术后第2~3天，两组6个时间点之间的SpO₂水平差异有统计学意义(F＝87.108，P<0.001)，观察组SpO₂水平(97.1±0.6)%高于对照组(95.1±0.3)%；两组患者拔除气管插管后第1~3天，观察组患者LAC水平低于对照组患者(F＝20.484，P<0.001)。

肩关节操联合呼吸训练能提高主动脉夹层开胸术后患者的血氧饱和度，降低患者血乳酸浓度，预防术后低氧血症的发生，有效促进患者呼吸功能的恢复。

To analyze the influence of shoulder joint exercises and breathing exercises on the rehabilitation of patients with aortic dissection.

A total of 76 patients underwent aortic dissection were randomly divided into the control group (n=38) and the observation group (n=38) from January 2019 to December 2020.The control group were given routine care after surgery, and the observation group adopted shoulder exercises and breathing exercises intervention on the basis of routine care. The differences in blood oxygen saturation (SpO₂), blood lactic acid level (LAC) and muscle strength levels were compared between the two groups of patients after surgery. Chi square test, variance analysis and t test were applied for data analysis.

On the second to third day after the operation, the differences in the SpO₂ levels at six time points between the two groups were statistically significant(F=87.108, P<0.001). The SpO₂ level in the observation group(97.1±0.6)% was higher than the control group (95.1±0.3)%. The LAC level of the observation group was lower than that of the control group on the first to third day after the tracheal intubation was removed(F=20.484, P<0.001).

Shoulder exercises combined with breathing exercises can increase the blood SpO₂ of the patients after aortic dissection thoracotomy and reduce the patient′s LAC concentration, prevent the occurrence of postoperative hypoxemia and effectively promote the recovery of respiratory function.