深吸气训练在肺癌开胸手术后患者中的应用价值
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摘要
目的:探讨深吸气训练在肺癌开胸手术后患者中的应用价值。方法:采用便利抽样的方法,研究时间为2014年8月至2018年2月,选择在我院进行开胸手术的肺癌患者134例,根据训练方法的不同分为观察组70例与对照组64例,对照组给予常规训练,观察组在对照组训练的基础上给予深吸气训练,两组训练观察时间为14 d,记录两组患者预后情况。结果:训练期间观察组与对照组的肺部并发症发生率分别为1. 4%和10. 9%,观察组显著低于对照组(P <0. 05)。术后14 d两组的最大通气量与用力肺活量都显著高于术后1d(P <0. 05),观察组也高于对照组(P <0. 05)。观察组术后14 d的膈肌活动度和膈肌厚度都高于术后1 d,也比对照组高,数据对比差异存在统计学意义(P <0. 05),在对照组中,时间点不同,数据间的对比差异没有统计学意义(P> 0. 05)。观察组术后14 d的情绪、认知、躯体、角色、社会功能等生活质量领域评分都显著高于对照组(P <0. 05)。结论:深吸气训练在肺癌开胸手术后患者中的应用能改善呼吸肌功能,使肺功能恢复正常,尽量减少出现肺部并发症,促使患者生活质量进一步提高。
Objective:To explore the value of deep inhalation training in lung cancer patients after thoracotomy.Methods:With a convenient sampling method,from August 2014 to February 2018,134 patients with lung cancer who underwent thoracotomy in a certain hospital were selected and were divided into the 70 patients in the observation group and the 64 patients in the control group according to the different training methods.The control group was received routine training,and the observation group was given the deep inhalation training on the basis of the training of the control group.The training time of the two groups was 14 days,and the prognosis of the two groups was recorded.Results:The incidences of pulmonary complications in the observation group and the control group were 1.4% and 10.9%,respectively,and the observation group was significantly lower than the control group(P<0.05).The postoperative 14 d of maximum ventilation and forced vital capacity of the two groups were significantly higher than postoperative 1 d,and the observation group was higher than the control group(P<0.05).The postoperative 14 d of diaphragmatic activity and diaphragm thickness of the observation group were higher than that of the control group and postoperative 1 d(P<0.05),and there was no significant difference in the control group at different time points(P>0.05).The postoperative 14 d of scores of life quality,such as emotion,cognition,body,role and social function,were significantly higher in the observation group than in the control group(P<0.05).Conclusion:The application of deep inhalation training in patients with lung cancer after thoracotomy can improve respiratory muscle function,promote normal lung function,reduce the incidence of pulmonary complications,and improve the quality of life of patients.
Objective:To explore the value of deep inhalation training in lung cancer patients after thoracotomy.Methods:With a convenient sampling method,from August 2014 to February 2018,134 patients with lung cancer who underwent thoracotomy in a certain hospital were selected and were divided into the 70 patients in the observation group and the 64 patients in the control group according to the different training methods.The control group was received routine training,and the observation group was given the deep inhalation training on the basis of the training of the control group.The training time of the two groups was 14 days,and the prognosis of the two groups was recorded.Results:The incidences of pulmonary complications in the observation group and the control group were 1.4% and 10.9%,respectively,and the observation group was significantly lower than the control group(P<0.05).The postoperative 14 d of maximum ventilation and forced vital capacity of the two groups were significantly higher than postoperative 1 d,and the observation group was higher than the control group(P<0.05).The postoperative 14 d of diaphragmatic activity and diaphragm thickness of the observation group were higher than that of the control group and postoperative 1 d(P<0.05),and there was no significant difference in the control group at different time points(P>0.05).The postoperative 14 d of scores of life quality,such as emotion,cognition,body,role and social function,were significantly higher in the observation group than in the control group(P<0.05).Conclusion:The application of deep inhalation training in patients with lung cancer after thoracotomy can improve respiratory muscle function,promote normal lung function,reduce the incidence of pulmonary complications,and improve the quality of life of patients.
引文
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[2] Li L,Gao XY,Li JH,et al.The short-term effect of systematically respiratory training on the respiratory function and motor function for patients with lung cancer operation[J].Chinese Journal of Rehabilitation Medicine,2016,31(11):1225-1229.[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.]
[3] Li Y,Wang P,Hu C,et al.Protein corona of airborne nanoscale PM2.5 induces aberrant proliferation of human lung fibroblasts based on a 3D organotypic culture[J].Sci Rep,2018,8(1):1939.
[4] Lai YT,Sui JH,Yang M,et al.Impact and effect of preoperative short-term pulmonary rehabilitation training on lung cancer patients with mild to moderate chronic obstructive pulmonary disease:A randomized trial[J].Chinese Journal of Lung Cancer,2016,19(11):746-753.[赖玉田,苏建华,杨梅,等.术前短期综合肺康复训练对肺癌合并轻中度慢性阻塞性肺病患者的影响:一项前瞻性随机对照试验[J].中国肺癌杂志,2016,19(11):746-753.]
[5] Li X,Yang H,Wu S,et al.Suppression of PTPN6 exacerbates aluminum oxide nanoparticle-induced COPD-like lesions in mice through activation of STAT pathway[J].Part Fibre Toxicol,2017,14(1):53.
[6] Liu SC,Liu YK,Xiong LF,et al.The effect of respiratory electrical stimulation training with biofeedback on the diaphragmatic motion and respiratory function for the patients with lung cancer after pulmonary resection[J].Chinese Journal of Rehabilitation Medicine,2018,33(6):630-635.[刘霜纯,刘亚康,熊丽芳,等.反馈式呼吸电刺激训练对肺癌术后患者膈肌运动和肺功能的影响[J].中国康复医学杂志,2018,33(6):630-635.]
[7] Yuksel H,Cayir Y,Kosan Z,et al.Effectiveness of breathing exercises during the second stage of labor on labor pain and duration:a randomized controlled trial[J].J Integr Med,2017,15(6):456-461.
[8] Jin Y,Wang J,Wu W.Application of deep breathing training in elderly patients at high risk after thoracotomy[J].Chongqing Medicine,2017,46(6):832-834.[金颖,王军,吴蔚.深吸气训练在开胸手术后高龄高危患者中的应用[J].重庆医学,2017,46(6):832-834.]
[9] Guo LP,Dong XF,Song ZH.Effect of respiratory function training on pulmonary function in patients with lung cancer in Ⅲa stage[J].Journal of Clinical Medicine in Practice,2016,20(18):35-38.[郭丽平,董晓芳,宋志红.呼吸功能训练对Ⅲa期肺癌患者肺功能的影响[J].实用临床医药杂志,2016,20(18):35-38.]
[10] Fischer B,Russell C,Sabioni P,et al.Lower-risk cannabis use guidelines:A comprehensive update of evidence and recommendations[J].Am J Public Health,2017,107(8):e1-e12.
[11] Jensen CA,Skottner N,Frengen J,et al.Development of a deep inspiration breath-hold system for radiotherapy utilizing a laser distance measurer[J].J Appl Clin Med Phys,2017,18(1):260-264.
[12] Yang X,Zhu J,Feng M.Effect of multiple health guidance modes on respiratory training compliance in lung cancer patients undergoing thoracoscopic lobectomy[J].Guangdong Medical Journal,2018,39(6):948-951,956.[杨霞,朱晶,冯梅.多元化健康指导模式对胸腔镜肺叶切除术肺癌患者术后呼吸训练依从性的影响[J].广东医学,2018,39(6):948-951,956.]
[13] Aksu T,Guler TE,Yalin K,et al.A novel deep inspiration maneuver for difficult transseptal puncture[J].Am J Cardiol,2017,119(3):428-433.
[14] Wang J,Li L,Han H,et al.Effects of pulmonary function training on the lung function and surgical tolerance of lung cancer patients with obstructive ventilatory defects[J].Chinese Journal of Physical Medicine and Rehabilitation,2017,39(3):202-206.[王静,李丽,韩辉,等.肺功能锻炼对阻塞性通气功能障碍肺癌患者肺功能及手术耐受性的影响[J].中华物理医学与康复杂志,2017,39(3):202-206.]
[15] Zambelli-Sim?es L,Martins MC,Possari JC,et al.Validation of scores of use of inhalation devices:valoration of errors[J].J Bras Pneumol,2015,41(4):313-322.
[16] Chen Y,Wang BQ,He X,et al.Effect of resistance respirator training on quality of life and lung function in patients with lung cancer after radiotherapy[J].Chinese Journal of Physical Medicine and Rehabilitation,2017,39(4):297-299.[陈勇,王宝强,何潇,等.阻力呼吸器训练对肺癌放疗后患者生命质量及肺功能的影响[J].中华物理医学与康复杂志,2017,39(4):297-299.]
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[19] Yang M,Zhong JD,Zhang JE,et al.The effects of enhancing confidence of active cycle of breathing technique training on pulmonary rehabilitation in elder lung cancer patients with lung resection[J].Chinese Journal of Nursing,2018,53(5):523-527.[杨梅,钟就娣,张俊娥,等.老年肺癌手术患者主动循环呼吸技术训练自信心培养的效果评价[J].中华护理杂志,2018,53(5):523-527.]
[20] Kelly CA,Maden M.How do health-care professionals perceive oxygen therapy?A critical interpretive synthesis of the literature[J].Chron Respir Dis,2015,12(1):11-23.
[21] Calzetta L,Rossi P,Bove P,et al.Novel and effective balanced intravenous-inhalant anaesthetic protocol in swine by using unrestricted drugs[J].Exp Anim,2014,63(4):423-433.
[22] Reis MS,Arena R,Archiza B,et al.Deep breathing heart rate variability is associated with inspiratory muscle weakness in chronic heart failure[J].Physiother Res Int,2014,19(1):16-24.
[23] Zhang YN,Lu SH.Effects of comprehensive respiratory function training on postoperative rehabilitation of patients with lung cancer[J].Journal of Beihua University(Natural Science),2017,18(6):784-787.[张燕楠,Lu Songhua.综合呼吸功能训练对肺癌患者术后康复的影响[J].北华大学学报(自然科学版),2017,18(6):784-787.]
[24] Massen JJ,Dusch K,Eldakar OT,et al.A thermal window for yawning in humans:Yawning as a brain cooling mechanism[J].Physiol Behav,2014,10(130):145-148.
[25] Li W,Wu X,Gao C.Ten-year epidemiological study of chemical burns in Jinshan,Shanghai,PR China[J].Burns,2013,39(7):1468-1473.