誘導型肺計量器普遍應用於心臟手術後病患，作為促進換氣與肺部擴張的方法；然而，臨床實際發現病患操作時深呼吸作法大多是採取會動用到肩頸及胸廓的胸式呼吸，而不是運用腹式呼吸。本研究目的旨比較腹式呼吸法與胸式呼吸法操作誘導型肺計量器在心臟手術後病患肺功能及心率變異影響之差異。
採實驗性設計，選取南部某兩所醫學中心接受正中胸骨切開之心臟手術病患共計31位，以抽籤方式隨機分派至兩組；組一（n = 16）介入腹式呼吸法操作誘導型肺計量器，組二（n = 15）則觀察並確認使用胸式呼吸法操作誘導型肺計量器。兩組操作次數為一天至少四回，一回十次。收集手術前、手術後轉入病房第一天與第三天之肺功能（用力肺活量百分比預測值、第一秒用力呼氣容積百分比預測值），以及每日測量兩次誘導型肺計量器操作前及操作後的心率變異（低頻功率、高頻功率、低頻功率比、高頻功率比、低高頻功率比）與心跳。以重複測量變異數分析檢視兩組在不同時間點肺功能、心率變異與心跳改變量之變化。
研究結果顯示兩組用力肺活量百分比預測值在時間與組別上出現交互作用（F = 9.233; p < .05，且腹式呼吸組比起胸式呼吸組能降低低頻功率比（F = 12.006; p < .05）、低高頻功率比（F = 7.664; p < .05）、心跳（F = 11.511; p < .05）以及增加高頻功率比（F = 12.006; p < .05）。驗證使用腹式呼吸法比使用胸式呼吸法操作誘導型肺計量器的肺功能恢復程度較佳，且能增加副交感神經驅動、降低交感神經驅動與減緩心跳。建議心臟手術後病患操作誘導型肺計量器時需確實以腹式呼吸法操作之。

Incentive spirometry has been commonly used to prevent postoperative lung atelectasis and pulmonary complications in patients who received cardiac surgery. However, clinically when using the incentive spirometry, patients often breathe through the method of stretching their chest unless clinical experts remind them to use abdominal breathing. The aim of this study was to examine the different breathing methods in using incentive spirometry on pulmonary function and heart rate variability in patients after cardiac surgery.
An experimental design was utilized in this study. Thirty-one patients undergoing median sternotomy for cardiac surgery from two medical centers in southern Taiwan were invited to participate. Group 1 (n = 16) received abdominal breathing method as an intervention in using incentive spirometry. Group 2 (n = 15) used incentive spirometry with thoracic breathing method. Implementations of the methods were applied four times daily, and ten tries each time per group.
Both groups received pulmonary function tests (% FVC pred, % FEV1 pred) before the operation and at day 1 and day 3 after postoperative transfer to the general ward. Heart rate variability (LF, LF%, HF, HF%, LF/HF ratio) were measured before the operation, pre and post the implementation of the incentive spirometry twice per day for a consecutive of three days after being transferred to the general ward. Data were analyzed through Repeated measures ANOVA.
The results showed significant interaction between the time and group in the % FVC pred (F = 9.233; p < .05). Additionally, when using the incentive spiromery, LF% (F = 12.006; p < .05), LF/HF ratio (F = 7.664; p < .05), HR (F = 11.511; p < .05) were reduced, and HF% (F=12.006; p < .05) was enhanced during abdominal breathing more than thoracic breathing. The present study demonstrated the optimal lung function recovery and also reflected a shift to the dominance of parasympathetic nerves regulation in using abdominal breathing rather than thoracic breathing with the application of incentive spiromery. We suggest that post-cardiac surgery patients use the abdominal breathing method when employing incentive spiromery.

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