预康复在促进老年肺癌手术患者术后康复中的应用研究

Application of Pre-rehabilitation in Promoting Postoperative Rehabilitation of Elderly Patients with Lung Cancer

目的研究预康复对老年肺癌手术患者肺功能、机体应激以及情感状况的影响。方法选择2020年10月至2022年12月于成都医学院第一附属医院行手术治疗的老年肺癌患者98例作为研究对象,依照随机数字表法分为预康复组(n=49)与对照组(n=49)。对照组行常规干预,预康复组行常规干预+预康复。观察两组胸管留置时间、术后1、3 d疼痛情况、总住院时间等手术相关指标。观察两组入院时、术前及术后1 h用力肺活量(FVC)、第1秒用力呼气容积(FEV1)及每分钟最大通气量(MVV)等肺功能指标;入院时、术前及术后7 d焦虑、抑郁评分;术后并发症。结果预康复组胸管留置时间、术后1、3 d疼痛情况、总住院时间均低于对照组(P<0.05)。术后1个月,预康复组FVC、FEV1、MVV均大于对照组(P<0.05)。术后7 d,预康复组焦虑、抑郁评分低于对照组(P<0.05)。预康复组术后并发症发生率低于对照组(P<0.05)。结论预康复可有效促进老年肺癌手术患者术后康复,提高其肺功能,改善其焦虑、抑郁情绪,对于改善患者预后具有重要作用。

Objective To study the effects of pre-rehabilitation on lung function,stress response and emotional status of elderly patients undergoing lung cancer surgery.Methods A total of 98 elderly patients with lung cancer who underwent surgical treatment in the First Affiliated Hospital of Chengdu Medical College from October 2020 to December 2022 were selected and divided into pre-rehabilitation group(n=49)and control group(n=49)according to random number table method.The control group received routine intervention,while the pre-rehabilitation group received routine intervention and pre-rehabilitation.Indicators related to surgery such as indwelling time of chest tube,postoperative pain on the 1st and 3rd day after operation,and total hospital stay in both groups were observed.Lung function indexes such as forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),and maximum ventilation volume per minute(MVV)at admission,before surgery and 1 h after surgery in both groups were observed.Emotional status such as anxiety and depression at admission,before surgery and 7 d after surgery in both groups were observed.Postoperative complications were compared between the two groups.Results The indwelling time of chest tube,postoperative pain on the 1st and 3rd day after operation,and total hospital stay in the pre-rehabilitation group were lower than those in the control group(P<0.05).One month after operation,FVC,FEV1 and MVV in the pre-rehabilitation group were higher than those in the control group(P<0.05).The scores of anxiety and depression in the pre-rehabilitation group were lower than those in the control group 7 d after surgery(P<0.05).The incidence of postoperative complications in the pre-rehabilitation group was lower than that in the control group(P<0.05).Conclusion Pre-rehabilitation can effectively promote postoperative rehabilitation of elderly patients with lung cancer by improving their lung function,anxiety and depression,and prognosis.