有氧运动训练对肺叶切除术后心肺运动功能及康复效果的影响

Effect of aerobic exercise on cardiopulmonary function and rehabilitation after lobectomy

目的探究有氧运动训练对肺叶切除术后心肺运动功能及康复效果的影响.方法选取2017年4月至2018年4月于哈尔滨医科大学附属第四医院接受肺叶切除术的88例患者为研究对象,按照随机数表法将所有患者分为两组,其中对照组44例,接受常规护理,观察组44例,接受常规护理联合有氧运动训练,比较两组患者的心肺功能变化、疲劳耐受评分和6 min步行距离(6MWT)变化以及生活质量水平变化.结果两组患者干预前肺活量(vital capacity,VC)、用力肺活量(forced vital capacity,FVC)、第1秒用力呼气量(forced expiratory volume in one second,FEV1)和运动心肺功能采用最大摄氧量(VO2max)比较差异无统计学意义(P>0.05),但干预后观察组的VC[(3.51±0.42)L vs.(3.26±0.35)L]、FVC[(2.63±0.44)L vs.(2.14±0.43)L]、FEV1[(2.11±0.28)L vs.(1.79±0.26)L]以及VO2max[(14.65±1.11)kg vs.(14.07±0.76)kg]均高于对照组,差异均具有统计学意义(均P<0.05).两组患者干预前疲劳耐受评分和6MWT比较差异无统计学意义(P>0.05),但干预后观察组患者的疲劳耐受评分低于对照组[(2.19±0.37)分vs.(3.07±0.41)分],6MWT高于对照组[(502.81±30.55)m vs.(476.33±30.09)m],差异具有统计学意义(P<0.05).干预前两组患者SF-36量表评分比较差异无统计学意义(P>0.05),干预后观察组患者SF-36量表评分高于对照组患者[(142.68±15.44)分vs.(121.94±15.71)分],差异具有统计学意义(P<0.05).结论有氧运动训练能够有效改善肺叶切除术患者的静息和运动心肺功能,对于恢复患者的运动能力,提高患者的生活质量水平具有积极作用,临床上值得推广.

Objective To explore the effect of aerobic exercise training on cardiopulmonary function and rehabilitation after lobectomy. Methods Eighty-eight patients who underwent lobectomy in the Fourth Affiliated Hospital of Harbin Medical University from April 2017 to April 2018 were selected and divided into two groups by the method of random number table. Forty-four cases in the control group were treated with routine care. And the integrate of routine nursing and aerobic exercise training was applied in 44 cases in the observation group.The changes of cardiopulmonary function, 6-minute walking distance(6 MWT) and quality of life as well as fatigue tolerance scores were compared between the two groups. Results There was no significant difference in VC, FVC, FEV1 and VO2max between the two groups before intervention(P>0.05), but the VC([3.51±0.42]L vs [3.26±0.35]L), FVC([2.63±0.44]L vs [2.14±0.43]L), FEV1([2.11±0.28]L vs [1.79±0.26]L)and VO2max([14.65±1.11]kg vs [14.07±0.76]kg) in the observation group after intervention were high than those in the control group significantly(P<0.05). There was no significant difference in the fatigue tolerance score and 6 MWT between the two groups(P>0.05). However, the fatigue tolerance score of the observation group was lower than that of the control group([2.19±0.37]vs [3.07±0.41]). 6 MWT was longer than that of the control group([502.81±30.55] m vs [476.33±30.09] m) significantly(P<0.05).Conclusions Aerobic exercise training can effectively improve the cardiopulmonary function of patients receiving lobectomy at rest and in motion. It has a positive effect on restoring the patient's exercise capacity and improving the patient's quality of life which is worthy of promotion in clinical practice.