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
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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.
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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[11]虞开波.康复运动锻炼对肺癌根治术患者术后肺功能和生活质量的影响[J].中国高等医学教育,2018(4):130-131.
[12]侯晓营,董翠萍,王君慧,等.肺康复训练对预防肺癌术后患者机械通气发生呼吸肌疲劳的效果研究[J].护士进修杂志,2018,33(14):1299-1301.
[13]高珂,赖玉田,黄健,等.非小细胞肺癌患者术前肺康复训练前后血清肺表面活性蛋白D(SP-D)改变与术后肺部并发症相关性的随机对照试验[J].中国胸心血管外科临床杂志,2017,24(5):330-337.
[14]周坤,苏建华,赖玉田,等.术前肺康复训练对肺癌患者术后肺炎的影响[J].中华胸部外科电子杂志,2017,4(3):164-170.
[15]张丽萍.肺康复运动训练在肺癌肺叶切除术患者护理中的应用[J].国际护理学杂志,2016,35(19):2650-2653.
[16]程彩萍,宋丽霞,李少芳,等.主动呼吸循环技术功能锻炼对胸部手术患者肺功能与患者快速康复的影响[J].心电图杂志(电子版),2017,6(2):191-193.
[17]曾帆.主动呼吸循环技术功能锻炼对机械通气患者肺功能与生活质量的影响[J].国际护理学杂志,2017,36(3):422-424.
[18]何静婷,喻姣花,王思桦.主动呼吸循环技术促进肺癌术后患者肺复张的效果分析[J].临床外科杂志,2018,26(3):208-211.
[19]钟就娣,刘莉,宋秀娟,等.主动呼吸循环技术对肺癌术后患者呼吸系统并发症发生的影响[J].现代临床护理,2016,15(3):56-59.
[20]王龙平,彭继海,张鸣生.主动呼吸循环技术在非小细胞肺癌肺叶切除术后快速康复中的临床应用[J].中国康复医学杂志,2018,33(6):642-646.
[2]孙中明,张芹,潘恩春,等.2009~2013年江苏省淮安市肺癌发病和死亡分析[J].中国肿瘤,2018,27(1):36-39.
[3]吴献华,龚永生,丁学兵,等.全胸腔镜肺癌根治术治疗早期非小细胞肺癌的临床研究[J].中国医学前沿杂志(电子版),2017,9(1):116-120.
[4]冯征,陈召,王居正,等.胸腔镜肺癌根治术与开胸肺癌根治术对肺癌患者临床疗效的影响及机制[J].现代生物医学进展,2016,16(31):6047-6050.
[5]郝志鹏,蔡奕欣,付圣灵,等.单孔与三孔胸腔镜肺癌根治术对患者术后疼痛及短期生活质量的对比研究[J].中国肺癌杂志,2016,19(3):122-128.
[6]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.
[7]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.
[8]郭卫东.电视胸腔镜辅助小切口与传统开胸手术治疗肺癌患者临床观察[J].中华肿瘤防治杂志,2016,23(7):465-466.
[9]宗石.胸腔镜肺癌根治术治疗高龄非小细胞肺癌患者的临床效果[J].中国药物经济学,2016,11(3):107-108.
[10]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.
[11]虞开波.康复运动锻炼对肺癌根治术患者术后肺功能和生活质量的影响[J].中国高等医学教育,2018(4):130-131.
[12]侯晓营,董翠萍,王君慧,等.肺康复训练对预防肺癌术后患者机械通气发生呼吸肌疲劳的效果研究[J].护士进修杂志,2018,33(14):1299-1301.
[13]高珂,赖玉田,黄健,等.非小细胞肺癌患者术前肺康复训练前后血清肺表面活性蛋白D(SP-D)改变与术后肺部并发症相关性的随机对照试验[J].中国胸心血管外科临床杂志,2017,24(5):330-337.
[14]周坤,苏建华,赖玉田,等.术前肺康复训练对肺癌患者术后肺炎的影响[J].中华胸部外科电子杂志,2017,4(3):164-170.
[15]张丽萍.肺康复运动训练在肺癌肺叶切除术患者护理中的应用[J].国际护理学杂志,2016,35(19):2650-2653.
[16]程彩萍,宋丽霞,李少芳,等.主动呼吸循环技术功能锻炼对胸部手术患者肺功能与患者快速康复的影响[J].心电图杂志(电子版),2017,6(2):191-193.
[17]曾帆.主动呼吸循环技术功能锻炼对机械通气患者肺功能与生活质量的影响[J].国际护理学杂志,2017,36(3):422-424.
[18]何静婷,喻姣花,王思桦.主动呼吸循环技术促进肺癌术后患者肺复张的效果分析[J].临床外科杂志,2018,26(3):208-211.
[19]钟就娣,刘莉,宋秀娟,等.主动呼吸循环技术对肺癌术后患者呼吸系统并发症发生的影响[J].现代临床护理,2016,15(3):56-59.
[20]王龙平,彭继海,张鸣生.主动呼吸循环技术在非小细胞肺癌肺叶切除术后快速康复中的临床应用[J].中国康复医学杂志,2018,33(6):642-646.