术前呼吸功能锻炼联合术后强化式呼吸道在老年肺癌胸腔镜术后康复中的效果

Effect of preoperative respiratory function exercise combined with postoperative intensive respiratory tract in elderly patients with lung cancer after thoracoscopic surgery

目的探讨术前呼吸功能锻炼联合术后强化式呼吸道在老年肺癌胸腔镜术后的康复效果。方法选择2017年8月~2019年9月在院接受肺癌胸腔镜手术治疗的老年患者100例作为研究对象。采用随机数表法分2组,每组50例。对照组采用常规护理,观察组则采用术前呼吸功能锻炼联合术后强化式呼吸道护理。比较患者术后康复情况,记录护理前后肺功能[时间最大通气量(MVV)、第一秒肺活量(FEV1)、用力肺活量(FVC)]变化及不同时间点视觉模拟疼痛(VAS)评分变化,统计不良反应。结果观察组的术后下床时间为(19.12±3.02)h、术后拔管时间为(3.15±0.65)d、住院时间为(8.13±2.11)d均短于对照组[(26.52±3.09)h、(4.59±0.68)d、(11.39±2.61)d],而住院费用[(2.89±0.31)万元]低于对照组[(3.32±0.42)万元](P<0.05);护理后,2组的MVV、FVC、FEV1均升高,且观察组[(50.13±3.45)、(79.85±4.79)%、(59.12±4.11)%]高于对照组[(46.52±3.09)、(70.18±5.12)%、(52.18±3.66)%](P<0.05);术后6 h、24 h、48 h及72 h,2组患者的VAS评分均降低,且观察组[(2.12±0.42)分、(1.98±0.31)分、(1.56±0.29)分、(1.21±0.21)分]低于对照组[(3.89±0.89)分、(2.56±0.41)分、(1.98±0.35)分、(1.59±0.13)分](P<0.05);观察组并发症发生率(6.00%)低于对照组的(20.00%)(P<0.05)。结论术前呼吸功能锻炼联合术后强化石呼吸道护理可改善患者肺功能,促进患者术后康复,有助于减轻术后疼痛,减少不良反应,值得临床推广运用。

Objective To explore the rehabilitation effect of preoperative respiratory function exercise combined with postoperative intensive respiratory tract in elderly patients with lung cancer after thoracoscopic surgery.Methods 100 elderly patients who received thoracoscopic surgery for lung cancer in our hospital from August 2017 to September 2019 were selected as the research objects.They were randomly divided into two groups,50 cases in each group.The control group was given routine nursing,while the observation group was given preoperative respiratory function exercise combined with postoperative intensive respiratory care.The recovery of patients after operation was compared.The changes of pulmonary function(MVV,FEV1,FVC)and visual analogue pain(VAS)scores at different time points were recorded before and after nursing,and adverse reactions were counted.Results The postoperative ambulation time,extubation time and hospitalization time of the observation group were(19.12±3.02)h,(3.15±0.65)D and(8.13±2.11)d,which were shorter than those of the control group[(26.52±3.09)h,(4.59±0.68)d,(11.39±2.61)D],while the hospitalization cost[(289±0.31)thousand yuan]was lower than that of the control group[(3.32±0.42)thousand yuan](P<0.05);after nursing,MVV,FVC,FEV1 of the two groups were increased,The observation group[(50.13±3.45),(79.85±4.79)%,(59.12±4.11)%]higher than the control group[(46.52±3.09),(70.18±5.12)%,(52.18±3.66)%](P<0.05);postoperative 6 h,24 h,24 h,48 H and 72 h after surgery,the VAS score of two groups of patients decreased,and the VAS score of two groups of patients decreased,and the observation group[(2.12±0.42),(1.98±0.31)scores,(1.56±0.29),(1.21±0.21)score]was significantly lower than the control group[3.89±0.89,2.56±0.41,1.98±0.35,1.59±0.13]scores.The complication rate of the observation group(6.00%)waslowerthan that in the control group(20.00%)(P<0.05).Conclusions Preoperative respiratory function exercise combined with postoperative intensive stone respiratory care can improve the lung function of patients,promote postoperative rehabilitation,help to reduce postoperative pain and reduce adverse reactions,which is worthy of clinical application.