路径式呼吸功能训练用于食管癌根治术后ERAS中的价值

Value of path-based respiratory function training in ERAS after radical resection of esophageal cancer

目的研究路径式呼吸功能训练用于食管癌根治术后加速康复外科(ERAS)中的价值。方法选择2019年9月~2021年9月临沂市肿瘤医院收治的136例行食管癌根治术的患者,使用单纯随机抽样法分为观察组(68例)和对照组(68例),对照组应用ERAS理念进行康复干预,观察组在对照组基础上进行路径式呼吸功能训练。比较两组术后恢复情况、干预不同时点血气指标[动脉氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、干预前后肺功能[最大通气量(MVV)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)]、术后并发症。结果与对照组相比,观察组术后住院时间、输液时间、肠内营养时间及胸腔引流管留置时间均较短,差异有统计学意义(P<0.05);两组术后首次肛门排气时间、术后首次排便时间差异无统计学意义(P>0.05);干预后3、7 d,两组PaO_(2)、PaCO_(2)水平呈下降趋势,差异有统计学意义(P<0.05);干预后7 d,与对照组相比,观察组PaO_(2)、PaCO_(2)水平较高,差异有统计学意义(P<0.05);干预后,两组MVV、FVC、FEV1水平均有所降低,但与对照组相比,观察组MVV、FVC、FEV1水平较高,差异有统计学意义(P<0.05);与对照组相比,观察组术后并发症发生率较低,差异有统计学意义(P<0.05)。结论路径式呼吸训练用于食管癌根治术后ERAS有利于加速患者康复。

Objective To study the value of path-based respiratory function training in accelerated rehabilitation surgery after radical resection of esophageal cancer(ERAS).Methods Choice in September 2019 to September 2021 in our hospital treated136 patients underwent esophageal cancer radical cohort study as the research object,using simple random sampling method was divided into observation group(68 cases)and control group(68 cases)and control group used ERAS concept for rehabilitation intervention,the observation group in the control group based on path type respiratory function training.Postoperative recovery,blood gas indexes at different time points of intervention[arterial oxygen partial pressure(PaO_(2)),arterial blood carbon dioxide partial pressure(PaCO_(2))],pulmonary function[maximal volume of air(MVV),forced vital capacity(FVC),forced expiratory volume in the first second(FEV1)]and postoperative complications were compared between the two groups.Results Compared with the control group,the postoperative hospitalization time,postoperative infusion time,postoperative enteral nutrition time,postoperative chest drainage tube indwelling time were shorter in the observation group(P<0.05);There was no significant difference in the time of first postoperative anal exhaust and first postoperative defecation between the two groups(P>0.05);At 3 and 7 days after intervention,the levels of PaO_(2)and PaCO_(2)in both groups showed a downward trend,(P<0.05);The PaO_(2)and PaCO_(2)levels in observation group were higher than those in control group at 7 days after intervention(P<0.05);After intervention,the levels of MVV,FVC and FEV1 in both groups were decreased(P<0.05);After intervention,compared with the control group,the levels of MVV,FVC and FEV1 in the observation group were higher(P<0.05);Compared with the control group,the incidence of postoperative complications in the observation group was lower(P<0.05).Conclusion Path breathing training is beneficial to accelerate the recovery of patients after radical resection of esophageal cancer.