术前预康复对60岁以上肺癌患者肺功能和运动耐力的影响

Effects of preoperative rehabilitation on pulmonary function and exercise capacity of lung cancer patients over 60 years old

目的:探讨术前预康复对60岁以上肺癌患者肺功能和运动耐力的影响。方法:40例60岁以上肺癌患者随机分为训练组和对照组。从入院至术前,对照组仅接受常规术前教育,训练组在常规术前教育的基础上接受系统的预康复。两组患者均在入院及术前进行肺功能评估和6分钟步行试验(6MWT)以评定训练疗效。结果:两组患者入院肺功能及6MWT比较,组间差异无显著性意义(P>0.05)。经过系统的呼吸和有氧训练,训练组术前FEV1、FVC、PEF及6MWT均显著高于入院时(P<0.05);对照组训练前后肺功能差异无显著性意义(P>0.05),术前6MWT显著低于入院时(P<0.05)。训练组肺功能变化值(术前-入院)dFEV1、dFVC和dPEF显著高于对照组(P<0.05);训练组d6MWT显著高于对照组(P<0.05)。训练组术后1月内肺部感染和肺不张的发生率均低于对照组(P<0.05)。结论:住院期间术前系统预康复可提高60岁以上肺癌患者肺功能和运动耐力,降低术后并发症的发生率。无预康复的60岁以上肺癌患者术前运动耐力降低。

Objective: To investigate the effects of preoperative rehabilitation on pulmonary function and exercise capacity of lung cancer patients over 60 years old of age. Method: Forty lung cancer patients (over 60 years old) were randomly enrolled into training group and control group. The patients in control group received only routine preoperative education and patients in training group had systematic preoperative rehabilitation as well as preoperative education before operation. Pulmonary function test and six-minute walk test (6MWT) were performed in both groups before and after training to assess the effect of intervention. Result: There was no significant difference pulmonary function and 6MWT between the two groups (P>0.05) at admission. After systematic breath training and aerobic exercise, the preoperative FEV1, FVC, PEF and 6MWT of the training group were significantly higher than admission (P<0.05). There was no significant difference in pulmonary function before and after training in the control group (P>0.05), and the preoperative 6MWT was significantly lower than that of admission (P<0.05). The changes of 6MWT,dFEV1, dFVC, dPEF and d6MWT in the training group were significantly higher than those in the control group (P<0.05). The incidence rate of pulmonary infection and atelectasis in one month after surgery in the training group was lower than that in the control group (P<0.05). Conclusion: Preoperative rehabilitation can improve pulmonary function and exercise capacity of lung cancer patients over 60 years old of age and reduce the incidence of postoperative complications. Preoperative exercise capacity of lung cancer patients over 60 years old of age who had no preoperative rehabilitation was reduced.