术前呼吸训练在食管胃结合部癌患者中的应用效果

Effect of preoperative ventilatory exercise on surgical treatment of adenocarcinoma of the esophagogastric junction

目的研究术前规范呼吸训练在加速康复外科的应用效果。方法回顾性分析86例行手术治疗的食管胃结合部癌患者的临床资料,将其分为对照组和试验组。对照组42例,进行适当的常规术前体格训练;试验组44例,进行规范的术前呼吸训练。比较两组患者手术前后肺功能指标、动脉血气指标以及术后相关恢复指标。结果术前两组患者VC、MVV、FEV1、动脉血氧分压、指末端动脉氧饱和度等指标比较,差异无统计学意义(P>0.05);术后两组患者相关指标均较术前有所降低,但试验组术后相关指标明显高于对照组,差异均有统计学意义(P<0.05);术后试验组肛门排气时间、有效住院时间以及预防性应用抗生素时间均较对照组明显缩短,差异有统计学意义(P<0.05);试验组总并发症发生率为4.5%(2/44),对照组总并发症发生率为14.3%(6/42),组间比较,差异有统计学意义(P<0.05)。结论 AEG患者进行术前呼吸训练,可减少术后并发症,加速患者康复,有效缩短住院时间,减轻患者经济负担。

Objective To study the application of preoperative standard breathing training in accelerated rehabilitation surgery. Methods A total of 86 cases of esophagogastric junction cancer treated with surgery were retrospectively analyzed. The patients were divided into control group and experimental group. The control group (n=42) underwent appropriate routine preoperative physical training. The experimental group(n=44) underwent standardized preoperative breathing training. The pulmonary function index, arterial blood gas index and postoperative related recovery index between two groups were compared before and after operation. Results There were no significant differences in VC, MVV, FEV1, arterial oxygen partial pressure, and terminal arterial oxygen saturation between the two groups (P>0.05). The postoperative indexes of the two groups were lower than those before surgery. However, the postoperative indexes of the experimental group were significantly higher than those of the control group, and the difference was statistically significant (P<0.05). The postoperative anal exhaust time, effective hospital stay, and prophylactic antibiotic time were significantly higher in the experimental group than those in the control group, and the difference was statistically significant (P<0.05). The total complication rate in the experimental group was 4.5%(2/44), and the total complication rate in the control group was 14.3%(6/42). The difference between the groups was statistically significant(P<0.05). Conclusion Preoperative respiratory training in patients with AEG can reduce postoperative complications, accelerate the recovery of patients, effectively shorten the length of hospital stay, and reduce the economic burden of patients.