摘要
目的探讨主动呼吸循环技术联合术前肺康复运动训练在老年肺癌患者胸腔镜术后快速康复中的作用。方法选择本院2016年1月至2018年6月收治的102例行胸腔镜手术的老年肺癌患者为研究对象,按照随机数表法将其分为对照组与观察组,每组各51例。两组患者均行肺癌胸腔镜手术,术前进行健康宣教。对照组患者术前接受肺康复运动训练,观察组患者在对照组基础上联合主动呼吸循环技术。比较两组患者干预前后血气指标、肺功能指标、6 min步行距离、呼气流量峰值及术后肺部并发症发生情况。结果与干预前相比,两组患者干预后动脉血氧分压和动脉血二氧化碳分压组间和组内比较差异均无统计学意义(均P> 0.05)。干预后,两组患者第1秒用力呼气容积(forced expiratory volume in one second,FEV_1)占预计值百分率(FEV_1%预计值)、FEV_1占用力肺活量(forced vital capacity,FVC)百分率(FEV_1/FVC)及呼气流量峰值均显著高于本组干预前(均P <0.05),6 min步行距离均显著长于本组干预前(均P <0.05),且观察组患者FEV1%预计值、FEV_1/FVC及呼气流量峰值均显著高于同期对照组(均P <0.05),6 min步行距离显著长于同期对照组(P <0.05)。观察组患者术后肺部感染、低氧血症及肺不张发生率均显著低于对照组(均P <0.05)。结论主动呼吸循环技术联合术前肺康复运动训练在老年肺癌胸腔镜术后快速康复中具有积极作用,可改善患者肺功能,降低术后肺部并发症发生率。
Objective To explore the role of active cycle of breathing technique(ACBT) combined with preoperative pulmonary rehabilitation exercise training in the rapid rehabilitation of elderly patients with lung cancer after thoracoscopic surgery. Method102 elderly patients with lung cancer who underwent thoracoscopic surgery in our hospital from January 2016 to June 2018 were selected as the study subjects. According to the random table method, they were divided into control group and observation group,51 cases in each group. Both groups received thoracoscopic surgery for lung cancer and health education before operation. Patients in control group received pulmonary rehabilitation exercise training before operation, while patients in observation group received ACBT on the basis of control group. The blood gas index, pulmonary function index, 6-minute walking distance, peak expiratory flow and pulmonary complications before and after intervention were compared between the two groups. Result Compared with before intervention, there were no significant differences in arterial partial pressure of oxyge and arterial partial pressure of carbon dioxide between the two groups(all P>0.05). After intervention, the predicted value of forced expiratory volume in one second(FEV_1%predicted value), the percentage of forced vital capacity(FVC) in FEV_1(FEV_1/FVC) and peak expiratory flow of the two groups were significantly higher than those before intervention(all P<0.05), and the 6-minute walking distance was significantly longer than that before intervention(all P<0.05). The FEV_1% predicted value, FEV_1/FVC and peak expiratory flow in observation group were significantly higher than those in control group(all P<0.05), and the 6-minute walking distance was significantly longer than that in control group(P<0.05). The incidence of pulmonary infection, hypoxemia and atelectasis in observation group was significantly lower than that in control group(all P<0.05). Conclusion ACBT combined with preoperative pulmonary rehabilitation exercise training is of great significance for the rapid rehabilitation of elderly patients with lung cancer after thoracoscopic surgery. It can improve the pulmonary function and reduce the incidence of pulmonary infection, which is worthy of clinical reference.
引文
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