术前不同呼吸训练方案结合心理干预对胸腔镜食管癌手术患者康复的影响

The effect of preoperative different respiratory training programs combined with psychological intervention on the recovery of patients undergoing thoracoscopic operation for esophagus cancer

目的比较术前不同呼吸训练方案结合心理干预对胸腔镜食管癌手术患者康复的影响。方法选取我院2017年2月至2018年1月120例胸腔镜食管癌手术患者为研究对象,按随机数表法分为缩唇呼吸组、吹气球组、呼吸训练器组,每组40例。三组患者入院后在常规心理干预基础上给予不同呼吸训练方案,缩唇呼吸组给予缩唇呼吸训练,吹气球组给予吹气球训练,呼吸训练器组给予呼吸训练器。检测患者血气分析指标,比较三组呼吸训练依从性与术后康复指标、肺部并发症发生率。结果呼吸训练器组完全依从率为95. 0%,显著高于缩唇呼吸组的75. 0%及吹气球组的60. 0%(P <0. 013);动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、氧合指数(OI)比较差异无统计学意义(P> 0. 05)。呼吸训练器组呼吸机使用时间、住院时间显著短于其他两组(P <0. 05),留置引流管时间差异无统计学意义(P> 0. 05)。三组肺部并发症总发生率比较差异无统计学意义(P=0. 115)。结论呼吸训练器可以提高胸腔镜食管癌手术患者术前呼吸训练依从性,避免术后肺功能进一步下降,加快康复进程。

Objective To compare the effect of preoperative different respiratory training programs combined with psychological intervention on the recovery of patients undergoing thoracoscopic operation for esophagus cancer.Methods We selected 120 patients undergoing the thoracoscopic operation for esophagus cancer in our hospital from February 2017 to January 2018 as subjects of the study.The patients were divided into the pursed lips breathing group,balloon blowing group and breath training device group by using the random number table method,40 in each group.On the basis of routine psychological intervention,the pursed lips breathing group was given pursed lips breathing training,the balloon blowing group was given balloon blowing training and the breath training device group was given breath training device.Indexes of pulmonary function were detected and blood gas analysis was performed.The respiratory training compliance and postoperative rehabilitation indexes were compared among the three groups.The incidence rate of pulmonary complications was statistically analyzed.Results The total compliance rate of the breath training device group was 95.0%that was significantly higher than that of the pursed lips breathing group(75.0%)or the balloon blowing group(60.0%)(P=0.013).However,there were no significant differences in arterial oxygen partial pressure(PaO2),arterial carbon dioxide partial pressure(PaCO2)or oxygenation index(OI)among the three groups(P>0.05).No significant difference in incidence of pulmonary complications was found among the three groups(P=0.115).Conclusion The breathing training device can improve the preoperative breathing training compliance of patients undergoing thoracoscopic operation for esophageal cancer,avoid further decline of postoperative lung function,and accelerate the patients’recovery.