主动循环呼吸功能锻炼对肺叶切除术后肺功能快速康复的影响

Effect of Active Circulatory Respiratory Exercise on Rapid Recovery of Pulmonary Function after Lobectomy

目的:探讨主动循环呼吸技术(ACBT)对胸腔镜肺癌切除术后肺功能快速康复的影响。方法:选取2018年1月至2020年3月在广州市番禺区中心医院诊断为Ⅰ~ⅢA期非小细胞肺癌患者107例,依据随机原则分为观察组(54例)与对照组(53例)。两组患者均进行胸腔镜肺叶切除手术,观察组术后进行ACBT,对照组术后进行常规肺康复治疗,比较两组患者术后第2天及术后2周肺功能[第1秒用力呼气容积(FEV1)、用力肺活量(FVC),每分钟最大通气量(MVV)]、疼痛程度[视觉模拟评分法(VAS)评分]和改良英国医学研究学会呼吸困难指数(mMRC)评分的变化。结果:两组患者术后2周与术后第2天组内比较,肺功能(FEV1、FVC和MVV)均明显提高,VAS评分和mMRC评分均明显降低,且观察组FEV1、FVC、VAS评分和mMRC评分的变化绝对值均明显大于对照组,差异均具有统计学意义(P<0.05)。结论:与术后常规肺康复治疗相比,ACBT可更有效改善胸腔镜肺癌切除术后肺功能,可促进快速康复,并减轻患者术后疼痛,提高生活质量。

Objective To investigate the effect of active circulatory breathing technology(ACBT)on rapid rehabilitation of lung function after thoracoscopic resection of lung cancer.Methods 107 patients with stageⅠ~Ⅲa non-small cell lung cancer diagnosed in the Central Hospital of Panyu District Guangzhou City from January 2018 to March 2020 were randomly divided into the observation group(n=54)and the control group(n=53).The patients in both groups were received thoracoscopic lobectomy,the observation group were received ACBT after operation,and the control group were received routine lung rehabilitation therapy after operation.The changes in pulmonary function〔forced expiratory volume in one second(FEV1),forced vital capacity(FVC),maximal voluntary ventilation(MVV)〕,degree of pain〔Visual analogue scale(VAS)score〕and modified British Society for medical research dyspnea index(mMRC)score of the two groups were compared on the second day and two weeks after operation.Results Compared with the second day after operation,the pulmonary function(FEV1,FVC and MVV)of the two groups increased significantly at 2 weeks after operation,VAS score and MMRC score of the two groups decreased significantly at 2 weeks after operation,and the absolute values of change in FEV1,FVC,VAS score and mMRC scorein the observation group were greater significantly than those in the control group(P<0.05).Conclusion Compared with postoperative routine lung rehabilitation therapy,ACBT can more effectively improve lung function after thoracoscopic resection of lung cancer,recover quickly,reduce postoperative pain,and improve quality of life.