短期术前不同强度吸气肌训练对肺叶切除术患者术后恢复效果的观察

Effects of short-term preoperative inspiratory muscle training of different intensities on the postoperative recovery effect of lobectomy patients

目的 探讨术前短期不同强度的吸气肌训练对胸腔镜肺叶切除术患者肺功能、运动耐量、术后并发症发生率、术后住院时间及胸腔引流管留置时间的干预效果,为患者提供合理的干预强度,加速患者康复提供参考依据。方法 选取2022年5月-2023年2月兰州大学第一医院胸外科接受胸腔镜肺叶切除术患者90例作为研究对象。按照组间基本特征具有可比性的原则分为对照组(常规训练)、中等强度组(30%MIP+常规训练)和高强度组(45%MIP+常规训练),每组30例。分别比较三组患者术后第5天肺功能变化量(△FEV1、△FVC、△PEF)、运动耐量变化量(△6WMD)、术后并发症发生率、术后住院时间及胸腔引流管留置时间。结果 三组患者肺功能变化量(△FEV1、△FVC)、运动耐量变化量(△6WMD)比较差异均具有统计学意义(P<0.05),肺功能变化量(△PEF)比较差异无统计学意义(P>0.05)。组间两两比较,高强度组的肺功能及运动耐量变化量与对照相比,差异均具有统计学意义(P<0.05);高强度组的肺功能变化量(△FVC)与中强度组相比,差异具有统计学意义(P<0.05);三组患者术后住院时间、胸腔引流管留置时间、术后并发症比较,差异均具有统计学意义(P<0.05),其中高强度组术后住院时间、胸腔引流管留置时间最短,并发症发生率最低。结论 短期术前高强度吸气肌训练可有效促进肺叶切除术患者术后肺功能恢复,提高步行能力,缩短胸腔引流管留置时间及术后住院时间,降低术后并发症的发生率,促进患者康复。

Objective To explore the intervention effect of short-term preoperative inspiratory muscle training of different intensities on lung function,exercise tolerance,postoperative complication rate,postoperative hospitalisation time and chest drain retention time of patients undergoing thoracoscopic lobectomy,to provide patients with reasonable intervention intensity and accelerate patients'recovery with reference basis.Methods 90 patients who underwent thoracoscopic lobectomy in the Department of Thoracic Surgery of the First Hospital of Lanzhou University from May 2022 to February 2023 were selected as study subjects.According to the principle of comparability of basic characteristics between groups,they were divided into the control group(conventional training),moderate intensity group(30%MIP+conventional training)and high intensity group(45%MIP+conventional training),with 30 cases in each group.The amount of changes in pulmonary function(△FEV1,△FVC,△PEF),the amount of changes in exercise tolerance(△6WMD),the incidence of postoperative complications,the duration of postoperative hospitalisation,and the duration of chest drain retention were compared among the three groups of patients in the 5th postoperative day,respectively.Results The diff erences between the three groups were statistically significant when comparing the amount of change in pulmonary function(△FEV1,△FVC)and exercise tolerance(△6WMD)(P<0.05),and the diff erence in the amount of change in pulmonary function(△PEF)was not statistically signifi cant(P>0.05).Comparing the two groups,the diff erence in the amount of change in lung function and exercise tolerance in the high-intensity group compared with the control was statistically signifi cant(P<0.05);the diff erence in the amount of change in lung function(△FVC)in the high-intensity group compared with the medium-intensity group was statistically signifi cant(P<0.05);the diff erence in the postoperative length of hospital stay,the duration of chest drain retention,and the postoperative complications among the three groups of patients was statistically signifi cant(P<0.05),of which the high intensity group had the shortest postoperative hospitalisation time,chest drain retention time and the lowest complication rate.Conclusion Short-term preoperative high-intensity inspiratory muscle training can eff ectively promote the recovery of postoperative pulmonary function,improve walking ability,shorten the time of chest drain retention and postoperative hospitalisation,reduce the incidence of postoperative complications,and promote the recovery of patients.