呼吸训练器在胸腔镜下非小细胞肺癌根治术后的应用

Application of breathing exerciser after thoracoscopic radical resection of non-small cell lung cancer

目的探讨呼吸训练器在胸腔镜下非小细胞肺癌(NSCLC)根治术后的应用。方法选取2018年1月至2019年12月我院胸外科住院的胸腔镜手术治疗的NSCLC根治术后患者92例,随机分为干预组和对照组,每组各46例。对照组予简易呼吸锻炼,干预组在对照组基础上予呼吸训练器锻炼,两组干预3个月。观察两组术前和干预3个月后肺功能指标、呼吸和运动功能的变化,并比较术后肺部并发症。结果干预3个月后,两组肺功能指标FEV1、FVC和MVV较术前明显下降(P<0.05或P<0.01),且治疗后干预组下降幅度低于对照组(P<0.05);两组Borg评分较术前明显上升,6MWT较术前明显下降(P<0.05或P<0.01),且治疗后干预组变化幅度低于对照组(P<0.05);干预组和对照组术后分别发生肺部并发症5例(10.87%)和13例(28.26%),干预组术后肺部并发症发生率低于对照组(χ2=4.421,P<0.05)。结论呼吸训练器用于胸腔镜下NSCLC根治术后不仅可促进患者肺功能、呼吸功能和运动能的恢复,而且可减少术后肺部并发症的发生。

Objective To explore the application of breathing exerciser after thoracoscopic radical resection of non-small cell lung cancer(NSCLC).Methods From January 2018 to December 2019,a total of 92 patients who were treated by thoracoscopic radical surgery of NSCLC in the department of thoracic surgery in our hospital were selected and randomly divided into an intervention group and a control group,with 46 cases in each group.The control group was given simple breathing exercises,and the intervention group was given breathing exerciser for exercise on the basis of the control group.The two groups were given the intervention for 3 months.The changes of lung function indices and respiratory and motor functions before the surgery and 3 months after intervention were observed in both groups,and postoperative pulmonary complications were compared.Results After 3 months of intervention,the pulmonary function indices of FEV1,FVC and MVV in both groups were significantly lower than those before the surgery(P<0.05 or P<0.01),and the rate of decrease in the intervention group after treatment was lower than that in the control group(P<0.05);the Borg score in both groups was significantly higher than that before the surgery,and 6MWT was significantly lower than that before the surgery(P<0.05 or P<0.01).After treatment,the magnitude of change in the intervention group was lower than that in the control group(P<0.05);pulmonary complications occurred in 5 cases(10.87%)and 13 cases(28.26%)in the intervention group and control group respectively.The incidence rate of postoperative pulmonary complications in the intervention group was lower than that in the control group(χ2=4.421,P<0.05).Conclusion The application of breathing exerciser after thoracoscopic radical resection of NSCLC can not only promote the recovery of patients'lung function,respiratory function and motor function,but also reduce the occurrence of postoperative pulmonary complications.