抗阻力呼吸训练对肺癌并气道高危患者术后康复的影响研究

Study on effect of resistive breathing training on postoperative rehabilitation of patients with lung cancer and high-risk airway

目的探讨抗阻力呼吸训练对肺癌并气道高危患者术后康复的影响。方法110例拟行胸腔镜手术合并气道高危因素的肺部阴影疑似肺癌患者110例,随机分成实验组和对照组,各55例。排除术后诊断为肺部良性病变、小细胞肺癌及中途退出者,最终97例患者被纳入研究,实验组48例,对照组49例。实验组行抗阻力呼吸训练+常规围手术期护理,对照组行常规围手术期护理。比较两组患者的术后一般资料(术后锻炼依从性评分、术后胸管留置时间、术后漏气时间、术后引流量),住院天数及并发症发生情况,6分钟步行距离(6MWD)、心率、血氧变化情况。结果实验组术后锻炼依从性评分50(50,52)分优于对照组的49(47,50)分,差异具有统计学意义(P<0.05);两组患者的术后胸管留置时间、术后漏气时间、术后引流量比较,差异无统计学意义(P>0.05)。实验组术后住院天数(5.77±1.51)d短于对照组的(6.53±1.63)d,差异具有统计学意义(P<0.05);两组患者的总住院天数、术前住院天数、术后并发症发生率比较,差异无统计学意义(P>0.05)。实验组手术后的6MWD(333.44±60.90)m长于对照组的(238.36±57.80)m,手术后6分钟步行试验(6MWT)步行后的血氧下降率0(0,1)%小于对照组的1(0,2)%,差异具有统计学意义(P<0.05);两组患者手术前的6MWD、手术后6MWT步行前的心率增加次数及血氧下降率、手术后6MWT步行后的心率增加次数比较,差异无统计学意义(P>0.05)。结论抗阻力呼吸训练+常规围手术期护理能够提高肺癌并气道高危患者术后肺康复训炼依从性,改善心肺功能,增强机体对手术的耐受力,降低术后并发症。

Objective To discuss the effect of resistive breathing training on postoperative rehabilitation of patients with lung cancer and high-risk airway.Methods A total of 110 cases of lung shadow suspected lung cancer patients with high-risk airway who were to undergo thoracoscopic surgery were randomly divided into experimental group and control group,with 55 cases in each group.Excluding patients diagnosed with benign lung lesions,small cell lung cancer and dropout,97 patients were finally included in the study,with 48 patients in the experimental group and 49 patients in the control group.The experimental group received resistive breathing training+conventional perioperative nursing,and the control group received conventional perioperative nursing.Both groups were compared in terms of postoperative general data(postoperative exercise compliance score,postoperative chest tube retention time,postoperative air leakage time,postoperative drainage volume),hospitalization days,occurrence of complications,6-min walking distance(6MWD),heart rate,and blood oxygen changes.Results The postoperative exercise compliance score of 50(50,52)points in the experimental group was better than that of 49(47,50)points in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups in terms of postoperative chest tube retention time,postoperative air leakage time and postoperative drainage volume(P>0.05).The postoperative hospital stay of(5.77±1.51)d in the experimental group was shorter than that of(6.53±1.63)d in the control group,and the difference was statistically significant(P<0.05).The differences were not statistically significant when comparing the total hospitalization days,preoperative hospitalization days,and postoperative complication rates of the two groups(P>0.05).The postoperative 6MWD of(333.44±60.90)m in the experimental group was longer than that of(238.36±57.80)m in the control group;the decrease rate of blood oxygen after 6-min walking test(6MWT)of 0(0,1)%in the experimental group was less than that of 1(0,2)%in the control group;the differences were statistically significant(P<0.05).The differences were not statistically significant when comparing the 6MWD before surgery,heart rate increase,decrease rate of blood oxygen before 6MWT after surgery,and heart rate increase after 6MWT after surgery between the two groups(P>0.05).Conclusion Resistive breathing training+conventional perioperative nursing can improve the compliance of lung rehabilitation training in patients with lung cancer and high-risk airway,improve cardiopulmonary function,enhance the body's tolerance to surgery,and reduce postoperative complications.