术前综合肺锻炼对原发性肺癌并发COPD患者疗效的影响

Effect of Preoperative Combined Lung Exercise on Surgical Treatment of Primary Lung Cancer Complicated with COPD

目的探讨术前综合肺锻炼对原发性肺癌并发COPD患者外科治疗效果的影响。方法选取接受外科开胸手术治疗的原发性肺癌并发COPD患者106例,采取随机数表法将患者分成对照组和实验组;对照组患者采用常规模式进行干预,主要为采取药物治疗的方式;实验组患者在对照组患者治疗的基础上进行7 d术前短期综合肺康复训练。观察比较两组患者在外科治疗后的临床特征、呼气峰值流速、6 min移动距离、运动疲劳指数、运动呼吸困难指数、血液气体分析、生活质量、PPCs发生率等数据。结果两组干预后的呼气峰值流速分别为(268.52±124.95)/(L·min^(-1))、(342.72±123.91)/(L·min^(-1)),6 min移动距离分别为(595.45±105.65)/m、(621.99±8.25)/m,能量消耗分别为(59.68±10.62)/Kcal、(61.14±10.63)/Kcal,实验组均高于对照组,数据差异具有统计学意义;两组干预后的运动疲劳指数、运动呼吸困难指数、血液气体分析、PH等数据比较无统计学意义;两组患者在外科治疗前生活质量评分比较无统计学意义;在干预后实验组患者的生活质量评分高于对照组患者(P<0.05);实验组患者与对照组患者的手术后发生肺部并发症发生率分别为15.09%、18.87%,数据差异不具有统计学意义(P>0.05)。结论术前综合肺锻炼能够增强原发性肺癌并发COPD患者外科治疗效果,提高患者的生存质量,值得临床推广。

Objective To explore the effect of preoperative combined lung exercise on surgical treatment of COPD patients with primary lung cancer. Methods 106 patients with primary lung cancer complicated with COPD who underwent surgical thoracotomy were randomly divided into the control group and the experimental group.The patients were randomly divided into the control group and the experimental group.The control group received conventional mode of intervention,mainly for drug treatment;the experimental group on the basis of the control group receied 7d preoperative short-term comprehensive lung rehabilitation training.The clinical characteristics,peak expiratory flow rate,6-minute moving distance,exercise fatigue index,exercise dyspnea index,blood gas analysis,quality of life,and incidence of PPCs were compared between the 2 groups. Results Results：Both groups after the intervention,the peak expiratory flow rate were 268.52±124.95（L/min）,342.72±123.91（L/min）,6 minute movement distance were 595.45±105.65（m）,621.99±8.25（m）,the energy consumption were 59.68±10.62（Kcal）、61.14±10.63（Kcal）,the experimental group was higher than those of the control group,with statistically significant difference;the intervention in the 2 groups in sports fatigue index,exercise dyspnea index,blood gas analysis,PH data had no statistically significant differernce;Both groups of patients in the pre surgical treatment quality of life score had no statistical significance;quality of life scores of the intervention group were higher than that of the control group（ P〈0.05）;the experimental group and the control group after surgery.The incidence of pulmonary complications were 15.09% and 18.87% respectively,and the difference was not statistically significant（ P〉0.05）. Conclusion Preoperative comprehensive lung exercise can enhance the surgical treatment of patients with primary lung cancer complicated with COPD,improve the quality of life of patients,it is worthy of clinical promotion.