快速康复外科理念指导下肩部功能操对老年肺癌胸腔镜术后患者疗效的影响

The effects of shoulder functional exercises under the guidance of the concept of rapid rehabilitation surgery on the elderly patients with lung cancer after thoracoscopic surgery

目的 探讨快速康复外科理念联合肩部功能操对老年肺癌胸腔镜术后患者快速康复和肺功能指标的影响。方法 选取2021年7月—2022年6月于空军军医大学第二附属医院胸腔外科收治并行单孔电视胸腔镜下肺癌根治术的老年患者357例,根据数字表法随机分为观察组(n=178)和对照组(n=179)。对照组予以常规临床管理,观察组在对照组的基础上予以快速康复外科以及肩部功能操等干预。观察并比较2组实验室检查指标值、并发症发生率以及肺功能指标值的差异。结果 与对照组比较,术后第3天和第7天观察组氧分压明显升高,二氧化碳分压明显降低、胸腔引流管拔除时间、肛门排气时间和总住院时间明显缩短(P<0.05)。与对照组比较,观察组术后第1天VAS评分明显降低,术后1周的用力肺活量、 1 s用力呼气容积和每分钟最大通气量均显著高于对照组(P<0.05)。结论 快速康复外科理念联合肩部功能操有助于加速老年肺癌胸腔镜术后患者的康复和改善肺功能,具有潜在的应用价值。

Objective To explore the effects of the concept of rapid rehabilitation surgery combined with shoulder functional exercise on the rapid rehabilitation and lung function indexes of elderly patients with lung cancer after thoracoscopic surgery.Methods From July 2021 to June 2022,357 elderly patients who were admitted to Department of Thoracic Surgery of Second Affiliated Hospital of Air Force Military Medical University and underwent single-port video-assisted thoracoscopic radical resection of lung cancer were selected and randomly divided into observation group(n=178) and control group(n=179) according to the number table method.The control group received routine clinical management,while the observation group received rapid rehabilitation surgery and shoulder functional exercise intervention on the basis of the control group.The differences of laboratory test index value,incidence of complication and pulmonary function index value between the two groups were observed and compared.Results Compared with the control group,the partial pressure of oxygen of the observation group increased significantly and the partial pressure of carbon dioxide decreased significantly on the 3 rd and 7 th days after operation(P<0.05);the removal time of thoracic drainage tube,anal exhaust time and total hospital stay of the observation group were significantly shorter(P<0.05);the VAS score of the observation group decreased significantly on the first day after operation(P<0.05).The forced vital capacity,forced expiratory volume in one second and maximal ventilation per minute of the observation group were significantly higher than those of the control group at 1 week after operation(P<0.05).Conclusion The concept of rapid rehabilitation surgery combined with shoulder functional exercise is helpful to accelerate the rehabilitation of elderly patients with lung cancer after thoracoscopic surgery and improve their lung function,which has potential application value.