渐进式膈肌锻炼对肺癌围手术期患者肺康复效果的影响

Effect of Progressive Diaphragm Muscle Training on Pulmonary Rehabilitation of Patients with Lung Cancer in the Perioperative Period

目的 探索渐进式膈肌锻炼在肺癌围手术期患者肺功能康复过程中的应用效果。方法 将64例行单孔胸腔镜肺叶切除术的肺癌患者按随机数字表法分为观察组和对照组,32名/组。对照组遵循胸外科常规流程化护理,观察组在对照组基础上进行渐进式膈肌锻炼。术前收集患者一般资料(患者填写部分),术前、术后第1天和术后第7天测量肺功能,对比术后并发症、胸腔闭式引流管留置时间及住院时间。结果 观察组术后第7天第1秒用力呼气容积(Forced Expiratory Volume in one second,FEV1)(F=14.610,P<0.001)、用力肺活量(Forced Vital Capacity,FVC)(F=10.411,P<0.05)、每分钟最大通气量(Maximal Voluntary Ventilation,MVV)(F=8.506,P<0.05)改善明显优于对照组;观察组胸腔闭式引流管留置时间[6.00(5.00,7.00)d]较对照组[6.50(5.00,9.00)d]短,差异具有统计学意义(P<0.05);观察组住院时间[12.00(11.00,14.75)d]短于对照组[14.00(11.25,16.75)d],差异有统计学差异(P<0.05);观察组术后并发症发生例数低于对照组,但差异无统计学意义(P>0.05)。结论 渐进式膈肌锻炼可加快肺癌患者术后肺功能康复的进程,提高患者生活质量。

Objective To explore the effect of progressive diaphragm muscle training in the rehabilitation of lung function in patients with lung cancer during perioperative period. Methods Sixty-four patients with lung cancer who underwent single-hole thoracoscopic lobectomy were randomly divided into experimental group(n=32) and control group(n=32). The control group followed the routine flow nursing of thoracic surgery, while the experimental group received progressive diaphragm exercise on the basis of the control group. The general data of the patients were collected before operation. The pulmonary function was measured before operation, the first day after operation and the 7 th day after operation. the postoperative complications, indwelling time of closed thoracic drainage tube and hospital stay were compared.Results The improvement of Forced Expiratory Volume in the first second(FEV1,F=14.610,P<0.001), Forced Vital Capacity(FVC,F=10.411,P<0.05) and Maximum Voluntary Ventilation(MVV) per minute(F=8.506,P<0.05) in the experimental group were significantly better than those in the control group. The indwelling time of closed thoracic drainage tube in the test group was significantly shorter than that in the control group [6.00(5.00,7.00) d vs 6.50(5.00,9.00) d, P<0.05], and the hospital stay in the test group was significantly shorter than that in the control group [12.00(11.00, 14.75) d] vs [14.00(11.25, 16.75) d, P<0.05]. The number of postoperative complications in the test group was lower than that in the control group, but the difference was not statistically significant(P>0.05). Conclusion Progressive diaphragm exercise can accelerate the rehabilitation of postoperative pulmonary function and improve the quality of life of patients with lung cancer.