围手术期视频宣教模式呼吸操对胸腔镜下肺癌手术患者的影响

Effect of perioperative video-mission mode breathing exercise on patients with thoracoscopic lung cancer surgery

目的评估围手术期医患互通结合视频宣教模式呼吸操训练对行胸腔镜下肺癌手术患者手术效果及术后并发症的影响。方法选取2019年4月至8月在江苏省人民医院胸外科将行胸腔镜下肺癌切除术的208例患者,随机分为对照组及干预组,每组104例。对照组给予常规围手术期护理,干预组除常规护理,于术前5~8 d及出院后10 d给予医患互通结合视频宣教模式呼吸操训练,对比两组患者术后住院、胸腔引流管留置时间及术后肺部并发症发生情况。结果干预组患者术后住院时间短于对照组[(4.01±1.27)d vs.(4.46±1.53)d],引流管留置时间也短于对照组[(2.57±1.16)d vs.(3.18±1.75)d],差异均有统计学意义。干预组患者术后30 d内肺部并发症总发生率较对照组降低(19.2%vs.37.5%),差异有统计学意义;但两组肺不张(0.9%vs.0.9%)、胸腔积液(7.7%vs.5.8%)发生率差异无统计学意义。结论围手术期医患互通结合视频宣教模式呼吸操训练能缩短手术患者的住院时间及引流管留置时间,减少术后并发症,促进患者快速康复。

Objective To evaluate the effect of perioperative doctor-patient communication combined with video missionary mode breathing exercises training on the surgical outcome and postoperative complications of patients undergoing thoracoscopic lung cancer surgery.Methods 208 patients receiveing thoracoscopic lung cancer resection in Department of Thoracic Surgery,Jiangsu Province Hospital were randomly divided into control group(CG)and intervention group(IG).The CG received routine perioperative nursing.The IG received routine perioperative nursing and breathing exercises for 5-8 days before surgery and 10 days after discharge.The differences between the two groups of postoperative hospital stay,chest drainage tube indwelling time,postoperative pulmonary complications(PPCS)were compared.Results The postoperative hospital stay in the intervention group was shorter than that in the control group([4.01±1.27]d vs.[4.46±1.53]d),and the extubation time([2.57±1.16]d vs.[3.18±1.75]d)was also shorter than that in the control group,and the differences were statistically significant.The total incidence of pulmonary complications within 30 days after surgery in the intervention group was lower than that in the control group(19.2%vs.37.5%),and the difference was statistically significant;however,there was no significant difference in the incidence of atelectasis(0.9%vs.0.9%)and hydrothorax(7.7%vs.5.8%).Conclusions The perioperative doctor-patient communication combined with video mission mode breathing exercises can shorten the hospitalization time and extubation time of surgical patients,reduce complications,and promote rapid recovery of patients.