呼吸锻炼专项护理在肺癌患者手术前及手术中的效果研究
|
摘要
目的探讨呼吸锻炼专项护理在肺癌患者手术前、中的应用效果。方法选择2017年1月-2018年3月在我院治疗的96例肺癌患者,采用随机数字表分为对照组(n=48)和观察组(n=48)。对照组给予心理干预、健康指导、术前宣教等常规护理,观察组在对照组基础上联合呼吸锻炼专项护理,两组均连续进行15 d护理干预,比较两组呼吸机使用、ICU停留、术后卧床及住院总时间、肺功能、肺癌预后因子及并发症发生率。结果观察组呼吸机使用、ICU停留、术后卧床休息、住院总时间均短于对照组(P<0.05)。两组护理前肺功能水平(FEV1、FVC、FEV1/FVC)差异无统计学意义(P>0.05);护理后15 d,观察组FEV1、FVC、FEV1/FVC水平,高于对照组(P<0.05)。两组护理前肺癌预后因子(VEGF、VEGFR2)水平差异无统计学意义(P>0.05);护理后15 d,观察组VEGF、VEGFR2水平,均低于对照组(P<0.05)。护理后,观察组心力衰竭、心律失常、肺炎肺不张、呼吸衰竭、支气管胸膜瘘等并发症发生率,低于对照组(P<0.05)。结论呼吸锻炼专项护理应用于肺癌患者手术前、中能缩短术后恢复时间,改善术后肺功能、肺癌预后因子水平,降低术后并发症发生率,值得推广应用。
Objective To study the effect of special nursing of breathing exercise on prognosis factors of patients with lung cancer before operation. Methods 96 patients with lung cancer treated from January to February 2018 were selected and divided into control group(n=48) and observation group(n=48) by random number table. Patients in control group received routine nursing such as psychological intervention, health guidance, preoperative education, etc. patients in observation group was received routine nursing combined with respiratory exercise special nursing. Patients in two groups were continuously treated for 15 days. The ventilator use, postoperative ICU stay, total bed rest and hospital stay, lung function, lung cancer prognosis factor and complication rate for the two groups were measured and compared. Results The total duration of ventilator use, ICU stay, postoperative bed rest and hospitalization in the observation group was shorter than that in the control group(P<0.05). There was no significant difference in pulmonary function between the two groups before nursing(P>0.05). FEV1, FVC, FEV1/FVC levels in the observation group were higher than those in the control group at 15 d after nursing(P<0.05). There was no statistically significant difference in VEGF and VEGFR2 levels between the two groups before nursing(P>0.05). VEGF and VEGFR2 levels of the observation group were all lower than those of the control group at 15 d after nursing(P<0.05). The incidence of heart failure, arrhythmia, pneumonia atelectasis, respiratory failure and bronchial pleural fistula in the observation group was lower than that in the control group(P<0.05). Conclusion Special nursing of respiratory exercise can shorten postoperative recovery time, improve postoperative lung function and prognosis factor of lung cancer, reduce the incidence of postoperative complications. It is worthy of popularization and application.
Objective To study the effect of special nursing of breathing exercise on prognosis factors of patients with lung cancer before operation. Methods 96 patients with lung cancer treated from January to February 2018 were selected and divided into control group(n=48) and observation group(n=48) by random number table. Patients in control group received routine nursing such as psychological intervention, health guidance, preoperative education, etc. patients in observation group was received routine nursing combined with respiratory exercise special nursing. Patients in two groups were continuously treated for 15 days. The ventilator use, postoperative ICU stay, total bed rest and hospital stay, lung function, lung cancer prognosis factor and complication rate for the two groups were measured and compared. Results The total duration of ventilator use, ICU stay, postoperative bed rest and hospitalization in the observation group was shorter than that in the control group(P<0.05). There was no significant difference in pulmonary function between the two groups before nursing(P>0.05). FEV1, FVC, FEV1/FVC levels in the observation group were higher than those in the control group at 15 d after nursing(P<0.05). There was no statistically significant difference in VEGF and VEGFR2 levels between the two groups before nursing(P>0.05). VEGF and VEGFR2 levels of the observation group were all lower than those of the control group at 15 d after nursing(P<0.05). The incidence of heart failure, arrhythmia, pneumonia atelectasis, respiratory failure and bronchial pleural fistula in the observation group was lower than that in the control group(P<0.05). Conclusion Special nursing of respiratory exercise can shorten postoperative recovery time, improve postoperative lung function and prognosis factor of lung cancer, reduce the incidence of postoperative complications. It is worthy of popularization and application.
引文
[1] 李露,高欣源,李剑华,等.系统呼吸训练对肺癌患者术后短期呼吸运动功能的疗效[J].中国康复医学杂志,2016,31(11):1225-1229.
[2] 许婷,洪静芳,祝志慧.幸福疗法对肺癌患者术前焦虑抑郁症状群及主观幸福感的影响[J].广东医学,2017,38(2):325-328.
[3] Leduc C, Antoni D, Charloux A, et al. Comorbidities in the management of patients with lung cancer[J]. European Respiratory Journal,2017,49(3):1601721.
[4] 任红亮,徐文贵,尤健,等.探讨PET/CT原发灶SUVmax在肺鳞癌患者术后预后中的意义及与临床病理特征的关系[J].中国肺癌杂志,2016,19(4):192-199.
[5] 范宜楚,汪笑冬,迟明友,等.术前新辅助化疗对局限期小细胞肺癌预后的影响研究[J].中国全科医学,2016,19(14):1653-1658.
[6] 江波,金从国,涂长玲,等.外周血循环肿瘤细胞EGFR表达对晚期非小细胞肺癌患者TKI治疗效果及预后的影响[J].山东医药,2016,56(40):86-88.
[7] 陈艳丽,王筱红.Peplau人际关系理论在肺癌患者护理中应用的可行性及有效性评价[J].护士进修杂志,2017,32(9):824-826.
[8] 黄静,蒋慧玲,何海珍,等.专项护理在小儿肺炎中的实施效果评价[J].中国现代医生,2016,54(4):157-159.
[9] Oikawa M,Hanada M,Nagura H,et al.Impact of peripheral muscle strength and functional exercise capacity on health-related quality of life after surgical treatment in patients with non-small-cell lung cancer[J].European Respiratory Journal,2016,48(60):4447.
[10] 李永丽,蔡曦光.肺癌患者血清VEGF-D、VEGFR-2水平及临床意义[J].中国现代医药杂志,2012,14(11):11-13.
[11] 加速康复外科(ERAS)理念在肺癌患者围手术期的应用效果[D].济南:山东大学,2017.
[12] Sveaas S H,Smedslund G,Hagen K B,et al.Effect of cardiorespiratory and strength exercises on disease activity in patients with inflammatory rheumatic diseases:A systematic review and meta-analysis[J].British Journal of Sports Medicine,2017,51(14):1065-1072.
[13] 李淑英,王春华,贺宇宏,等.团队合作在血标本分析前质量管理中的实践与效果[J].中国现代医学杂志,2016,26(11):137-140.
[14] 杜军华,乔洪源,尹宜发.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137-140.
[15] 张锦锋,张友惠,袁丽敏,等.医院社区一体化延续护理在肺癌患者胸腔镜术后的应用[J].护士进修杂志,2016,31(14):1310-1313.
[16] Jeong J H,Yoo W G,Effect of caregiver education on pulmonary rehabilitotion,respiratory muscle strength and dyspnea in lung cancer patients[J].Journal of Physical Therapy Science,2015,27(6):1653-1654.
[2] 许婷,洪静芳,祝志慧.幸福疗法对肺癌患者术前焦虑抑郁症状群及主观幸福感的影响[J].广东医学,2017,38(2):325-328.
[3] Leduc C, Antoni D, Charloux A, et al. Comorbidities in the management of patients with lung cancer[J]. European Respiratory Journal,2017,49(3):1601721.
[4] 任红亮,徐文贵,尤健,等.探讨PET/CT原发灶SUVmax在肺鳞癌患者术后预后中的意义及与临床病理特征的关系[J].中国肺癌杂志,2016,19(4):192-199.
[5] 范宜楚,汪笑冬,迟明友,等.术前新辅助化疗对局限期小细胞肺癌预后的影响研究[J].中国全科医学,2016,19(14):1653-1658.
[6] 江波,金从国,涂长玲,等.外周血循环肿瘤细胞EGFR表达对晚期非小细胞肺癌患者TKI治疗效果及预后的影响[J].山东医药,2016,56(40):86-88.
[7] 陈艳丽,王筱红.Peplau人际关系理论在肺癌患者护理中应用的可行性及有效性评价[J].护士进修杂志,2017,32(9):824-826.
[8] 黄静,蒋慧玲,何海珍,等.专项护理在小儿肺炎中的实施效果评价[J].中国现代医生,2016,54(4):157-159.
[9] Oikawa M,Hanada M,Nagura H,et al.Impact of peripheral muscle strength and functional exercise capacity on health-related quality of life after surgical treatment in patients with non-small-cell lung cancer[J].European Respiratory Journal,2016,48(60):4447.
[10] 李永丽,蔡曦光.肺癌患者血清VEGF-D、VEGFR-2水平及临床意义[J].中国现代医药杂志,2012,14(11):11-13.
[11] 加速康复外科(ERAS)理念在肺癌患者围手术期的应用效果[D].济南:山东大学,2017.
[12] Sveaas S H,Smedslund G,Hagen K B,et al.Effect of cardiorespiratory and strength exercises on disease activity in patients with inflammatory rheumatic diseases:A systematic review and meta-analysis[J].British Journal of Sports Medicine,2017,51(14):1065-1072.
[13] 李淑英,王春华,贺宇宏,等.团队合作在血标本分析前质量管理中的实践与效果[J].中国现代医学杂志,2016,26(11):137-140.
[14] 杜军华,乔洪源,尹宜发.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137-140.
[15] 张锦锋,张友惠,袁丽敏,等.医院社区一体化延续护理在肺癌患者胸腔镜术后的应用[J].护士进修杂志,2016,31(14):1310-1313.
[16] Jeong J H,Yoo W G,Effect of caregiver education on pulmonary rehabilitotion,respiratory muscle strength and dyspnea in lung cancer patients[J].Journal of Physical Therapy Science,2015,27(6):1653-1654.