分级呼吸训练方式对食管癌患者呼吸功能的影响

Effect of graded respiratory training method on respiratory function of esophageal cancer patients

目的探讨常规呼吸训练和分级呼吸训练对食管癌患者呼吸功能等指标的影响。方法回顾性分析2020年1月至2021年6月上海交通大学医学院附属仁济医院的食管癌患者资料,将2020年1~9月接受常规呼吸训练的50例食管癌患者设为对照组,将2020年10月至2021年6月接受常规呼吸训练联合分级呼吸训练的50例食管癌患者设为观察组。比较2组患者的呼吸功能、呼吸肌力量、术后康复指标及肺部并发症发生情况。结果出院时,2组的最大自主通气量(MVV)、肺活量(VC)、第1秒用力呼气容积(FEV1)均较干预前增加(P均<0.05);观察组的MVV、VC及FEV1均高于对照组(P均<0.05)。出院时,2组的最大吸气压(MIP)、最大呼气压(MEP)均较干预前减小(P均<0.05),但观察组的MIP、MEP均高于对照组(P均<0.05)。观察组的单肺通气时间、呼吸机使用时间及住院时间均短于对照组(P均<0.05)。观察组在干预期间的肺部并发症(胸腔积液和肺部感染)总发生率低于对照组(P<0.05)。结论食管癌患者术前接受分级呼吸训练可促进其呼吸功能及呼吸肌力量的恢复,降低肺部并发症发生率,促进术后尽早康复。

Objective To explore the effects of routine respiratory training and graded respiratory training on the respiratory function and other indicators of patients with esophageal cancer.Methods The data of esophageal cancer patients at Renji Hospital,Shanghai Jiao Tong University School of Medicine from January 2020 to June 2021 were retrospectively analyzed.The 50 esophageal cancer patients who received routine respiratory training from January to September 2020 were set as the control group,and the 50 esophageal cancer patients who received routine respiratory training and graded respiratory training from October 2020 to June 2021 were set as the observation group.The respiratory function,respiratory muscle strength,postoperative rehabilitation indicators,and pulmonary complications were compared between the two groups.Results At discharge,the maximum voluntary ventilation(MVV),vital capacity(VC),and forced expiratory volume in 1 second(FEV_(1))of the two groups were increased compared with those before the intervention(all P<0.05),and the MVV,VC,and FEV_(1) of the observation group were higher than those of the control group(all P<0.05).At discharge,the maximum inspiratory pressure(MIP)and maximum expiratory pressure(MEP)of the two groups were decreased compared with those before the intervention(all P<0.05),but the MIP and MEP of the observation group were higher than those of the control group(both P<0.05).At discharge,the duration of single-lung ventilation,duration of ventilator use,and length of hospital stay in the observation group were shorter than those in the control group(all P<0.05).During the intervention,the total incidence of pulmonary complications(pleural effusion and pulmonary infection)in the observation group was lower than that in the control group(P<0.05).Conclusion Preoperative graded respiratory training for esophageal cancer patients can promote the recovery of respiratory function and respiratory muscle strength,reduce the incidence of pulmonary complications,and promote the early postoperative recovery.