目的驱动理念指导下多维呼吸功能训练对肺癌患者围手术期肺功能的影响

Effects of multi-dimensional respiratory function training under guidance of goal-driven concept on perioperative lung function in patients with lung cancer

目的:探讨目的驱动理念指导下多维呼吸功能训练对肺癌患者围手术期肺功能的影响。方法:选取某院接受肺癌根除术的患者88例,按照随机数字表法分为观察组和对照组,每组44例。对照组行常规护理,观察组在对照组基础上实施目的驱动理念指导下多维呼吸功能训练,2组持续干预10 d。干预前后,采用肺功能检测仪检测患者第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气流量峰值(PEF)、每分钟最大通气量(MVV);采用血气分析仪检测PaO_(2)、PaCO_(2)和血氧饱和度(SpO_(2));比较2组患者术后康复相关指标和并发症发生情况。结果:干预后,观察组患者FVC、FEV1、PEF和MVV分别为(2.37±0.29)L、(2.20±0.23)L、(5.87±0.67)L/s、(79.63±8.04)L/min,均高于对照组的(2.08±0.25)L、(1.91±0.21)L、(5.11±0.62)L/s、(75.34±7.79)L/min(P<0.05);观察组患者PaO_(2)和SpO_(2)水平分别为(79.54±8.05)mmHg、(98.21±9.88)%,明显高于对照组的(75.82±7.82)mmHg、(93.64±9.45)%,PaCO_(2)[(38.86±4.02)mmHg]低于对照组[(41.42±4.17)mmHg](P<0.05);观察组患者导管留置时间、呼吸机使用时间、下床活动时间和住院时间分别为(45.68±5.31)h、(15.76±2.04)h、(58.37±6.13)h、(6.58±0.78)d,明显少于对照组的(56.47±6.42)h、(18.64±2.65)h、(67.42±7.27)h、(9.46±1.38)d,每日排痰量[(46.28±4.78)mL]多于对照组[(37.86±4.12)mL](P<0.05);观察组患者术后并发症总发生率为13.64%低于对照组患者的31.82%(P<0.05)。结论:目的驱动理念指导下多维呼吸训练可改善肺癌患者术后肺功能,降低术后并发症的发生。

Objective:To explore the effects of multi-dimensional respiratory function training under the guidance of goal-driven concept on perioperative lung function in patients with lung cancer.Methods:A total of 88 patients with lung cancer undergoing elective radical resection in a hospital were enrolled and were randomly divided into an observation group and a control group,44 cases in each.The control group was given routine nursing,while the observation group was additionally given multi-dimensional respiratory function training under the guidance of goal-driven concept.All were continuously intervened for 10d.Before and after the intervention,forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),peak expiratory flow(PEF)and maximal voluntary ventilation(MVV)were detected by lung function tester.The partial pressure of arterial blood oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2))and blood oxygen saturation(SpO_(2))were detected by blood gas analyzer.The postoperative recovery related indexes and the occurrence of complications were compared between the two groups.Results:After the intervention,FVC,FEV1,PEF and MVV in the observation group were(2.37±0.29)L,(2.20±0.23)L,(5.87±0.67)L/s and(79.63±8.04)L/min respectively,higher than the control group's(2.08±0.25)L,(1.91±0.21)L,(5.11±0.62)L/s,(75.34±7.79)L/min(P<0.05).PaO_(2) and SpO_(2) in the observation group were(79.54±8.05)mmHg and(98.21±9.88)%,significantly higher than those in control group[(75.82±7.82)mmHg,(93.64±9.45)%],while PaCO_(2) was lower than that in the control group[(38.86±4.02)mmHg vs(41.42±4.17)mmHg](P<0.05).The catheter indwelling time,using time of ventilator,leaving bed time and hospitalization time of the observation group were(45.68±5.31)h,(15.76±2.04)h,(58.37±6.13)h and(6.58±0.78)d,significantly shorter than those in the control group[(56.47±6.42)h,(18.64±2.65)h,(67.42±7.27)h,(9.46±1.38)d],and daily sputum excretion was significantly more than that in the control group[(46.28±4.78)mL vs(37.86±4.12)mL](P<0.05).The total incidence of postoperative complications in the observation group was significantly lower than that in the control group(13.64%vs 31.82%)(P<0.05).Conclusion:The multi-dimensional respiratory function training under the guidance of goal-driven concept can improve lung function and reduce postoperative complications in patients with lung cancer.