缩唇腹式呼吸训练与肺功能锻炼对肺癌手术患者肺部感染的影响

Effects of lip-abdominal breathing training and lung function exercise regimens on postoperative pulmonary infections in patients with lung cancer

目的探讨肺功能呼吸训练器对肺癌手术患者肺部感染的影响。方法选取2016年2月-2017年2月医院收治的肺癌手术治疗患者216例为研究对象,随机分为试验组和对照组,各108例。对照组术后采用缩唇腹式呼吸训练,试验组采用肺功能训练器进行训练。统计两组肺部感染发生情况,并进行病原菌检测;测定第1秒用力呼气容积(FEV_1)、呼气峰流速(PEF)、肺活量(VC)、用力肺活量(FVC)、肺总量(TLC)和残气量(RV);统计两组患者住院时间、住院费用和胸导管留置时间。结果试验组肺部感染率为3.70%(4/108)低于对照组14.81%(16/108)(P=0.032);共培养分离病原菌32株,其中革兰阴性菌24株占75.00%,以肺炎克雷伯菌为主;革兰阳性菌8株占25.00%,以金黄色葡萄球菌为主。试验组FEV_1、PEF、FVC、VC为(78.11±6.32)%、(4.11±0.12)L/s、(2.66±0.45)L、(2.75±0.16)L高于对照组(P<0.05),RV为(1.62±0.35)L低于对照组(P=0.011),两组TLC比较差异无统计学意义(P=0.091)。试验组住院时间、住院费用及胸导管留置时间分别为(15.36±3.58)天、(3.56±1.15)万元及(3.43±1.02)天低于对照组(P<0.05)。结论对肺癌手术患者采用肺功能训练器进行肺功能锻炼,可改善肺功能,有效预防肺部感染,具有一定的临床价值。

OBJECTIVE To investigate the effect of pulmonary function breathing apparatus on postoperative pulmonary infections in patients with lung cancer.METHODS A total of 216 patients with lung cancer surgery from Feb.2016 to Feb.2017 were enrolled in the study.They were randomly divided into the experimental group and the control group,108 cases each.In the control group,the lip-abdominal breathing training was used,and the experimental group was trained by the pulmonary function trainer.The incidence of pulmonary infection was determined and pathogens were detected.The first second forced expiratory volume（FEV_1）,peak expiratory flow（PEF）,vital capacity（VC）,forced vital capacity（FVC）,and total lung volume（TLC）and residual volume（RV）were measured.The statistics of hospital stay,hospitalization costs,and chest catheter indwelling time were recorded.RESULTS The lung infection rate in the experimental group was 3.70%（4/108）,which was significantly lower than that in the control group,14.81%（16/108）（P=0.032）.A total of 32 strains of pathogens were isolated from co-culture,of which 24 strains were gram-negative bacteria accounting for 75.00%,dominated by Klebsiella pneumoniae;8 strains were gram-positive bacteria accounting for 25.00%,dominated by Staphylococcus aureus.The FEV1,PEF,FVC,VC of the experimental groups were（78.11±6.32）%,（4.11±0.12）L/s,（2.66±0.45）L,（2.75±0.16）L,significantly higher than the control group（P〈0.05）.The RV was（1.62±0.35）L,significantly lower than the control group（P=0.011）,and there was no significant difference in TLC between the two groups（P=0.091）.The hospitalization time,hospitalization cost and chest catheter indwelling time were（15.36±3.58）d,（3.56±1.15）yuan and（3.43±1.02）d significantly,lower than those of the control group（P〈0.05）.CONCLUSIONPulmonary function training for lung function surgery in patients with lung cancer can improve their lung function and effectively prevent lung infection.It has certain clinical value.