术前抗阻呼吸训练在老年食管癌患者中的应用效果

Effect of Preoperative Anti-obstructive Breathing Training in Elderly Patients with Esophageal Cancer

目的探究老年食管癌(EC)患者术前应用抗阻呼吸训练预防术后肺部感染的效果。方法选取我院2019年4月至2021年4月125例老年EC手术患者作为研究对象,依据干预模式分为常规组和抗阻组。常规组62例术前实施预防术后肺部并发症常规宣教及指导呼吸训练,抗阻组63例术前增加抗阻呼吸训练,对比两组患者肺功能,肺泡血氧交换能力,氧化应激指标,并发症发生情况。结果两组患者术后1周末肺活量(VC)、最大通气量(MVV)水平较干预前升高,抗阻组高于常规组(P<0.05)。两组患者术后1周末氧分压(PaO_(2))、氧合指数(OI)水平较干预前降低,抗阻组降低幅度高于常规组;肺泡动脉氧分压差(PA-aDO_(2))水平较干预前升高,抗阻组升高幅度低于常规组(P<0.05)。两组患者术后1周末丙二醛(MDA)水平较干预前降低,抗阻组低于常规组;超氧化物歧化酶(SOD)水平较干预前升高,抗阻组高于常规组(P<0.05)。抗阻组并发症发生率1.59%(1/63)低于常规组4.84%(3/62),差异无统计学意义(P>0.05)。结论术前应用抗阻呼吸训练可改善老年EC患者肺功能,调节肺泡血氧交换能力,安全性较高,提高临床疗效。

Objective To investigate the effect of preoperative anti-obstructive breathing training on preventing postoperative pulmonary infection in elderly patients with esophageal cancer(EC)Methods 125 elderly patients undergoing EC surgery in our hospital from April 2019 to April 2021 were selected and divided into 2 groups.62 patients in the conventional group received routine education and guidance of respiratory training to prevent postoperative pulmonary complications,and 63 patients in the anti-obstructive group received anti-obstructive respiratory training,before operation.The pulmonary function,alveolar blood oxygen exchange capacity,oxidative stress indicators and complications were compared between the 2 groups.Results At the end of 1 week after operation,the levels of vital capacity(VC)and maximum ventilation volume(MVV)in the 2 groups were higher than those before the intervention,and those in the anti-obstructive group were higher than those in the conventional group(P<0.05);the levels of oxygen partial pressure(PaO_(2))and oxygenation index(OI)in the 2 groups were lower than those before intervention,and the reduction of PaO_(2) and OI in the anti-obstructive group was higher than that in the conventional group;the level of alveolar arterial oxygen partial pressure difference(PA-aDO_(2))was higher than that before the intervention,and the elevation of the anti-obstructive group was lower than that of the conventional group(P<0.05);the level of malondialdehyde(MDA)in the 2 groups was lower than that before intervention,and the level in the anti-obstructive group was lower than that in the conventional group;the level of superoxide dismutase(SOD)in the anti-obstructive group was higher than that in the conventional group(P<0.05).The complication rate of the anti-obstructive group was 1.59%(1/63),which was lower than that of the conventional group(4.84%,3/62),and the difference was not statistically significant(P>0.05).Conclusion The preoperative application of anti-obstructive breathing training could improve the pulmonary function of elderly patients with EC,regulate the alveolar blood oxygen exchange capacity,with high safety and improve the clinical efficacy.