量化式主动呼吸循环技术对食管癌术后患者肺功能及并发症的影响

Impact of quantitative active respiratory and circulatory technology on lung function andcomplications in postoperative patients with esophageal cancer

目的分析基于诱发性肺量计的量化式主动呼吸循环技术对食管癌根治术后患者肺功能及肺部相关并发症的影响。方法选取2021年4月~2023年10月于空军军医大学第二附属医院行食管癌根治术的117例患者,将患者随机分为常规组(n=58,进行缩唇呼吸训练,3次/d)和量化式主动呼吸循环技术(ACBT)组(量化ACBT组)(n=59,使用诱发性肺量计行量化训练)。比较两组患者术前、术后3 d和术后7 d用力肺活量占预计值百分比(FVC%)、第1秒用力呼气量占预计值百分比(FEV1%)、每分钟最大通气量占预计值百分比(MVV%)。比较两组患者术后2、3和5 d痰液清除效果及视觉模拟评分法(VAS)评分,以及术后肺部并发症发生率。结果量化ACBT组患者术后3 d和术后7 d的FVC%、MVV%以及术后7 d的FEV1%均高于常规组患者,差异均有统计学意义(P<0.05)。术后2、3和5 d,量化ACBT组患者的痰液清除优良率均高于常规组患者,差异均有统计学意义(P<0.05)。术后2、3和5 d,量化ACBT组患者的VAS评分略高于常规组,但差异无统计学意义(P>0.05)。量化ACBT组患者的肺部相关并发症发生率为6.77%(4/59),低于常规组患者的18.96%(11/58),差异有统计学意义(χ^(2)=3.885,P=0.048)。结论对于微创食管癌根治术患者,术后采用基于诱发性肺量计的量化主动呼吸循环技术训练有助于排出痰液,改善患者的肺功能,降低胸部并发症的发生率。

Objective To analyze the impact of quantitative active respiratory and circulatory technology based on incentive spirometer on lung function and pulmonary related complications in postoperative patients with esophageal cancer.Methods Patients who underwent esophageal cancer radical surgery in our hospital from April 2021 to October 2023 were selected.There were 58 cases in the conventional group and 59 cases in the quantitative active respiratory and circulatory technology group(quantitative ACBT group).The routine group received pursed-lip breathing training 3 times a day,while the quantitative ACBT group received quantitative training using an inducible spirometer.The inhalation volume was set according to age,gender,and height,and the ACBT cycle of respiratory control chest expansion forced exhalation was trained 3 times a day.Compare the percentage of forced vital capacity(FVC%),the percentage of forced vital capacity in the first second(FEV1%),and the percentage of maximum ventilation per minute(MVV%)between the two groups before surgery,3 days after surgery,and 7 days after surgery.Compare the sputum clearance effect and pain visual analogue scale(VAS)at 2,3,and 5 days after surgery,and compare the incidence of pulmonary complications.Results The quantitative ACBT group had higher FVC%,MVV%,and FEV1%at 3 and 7 days after surgery compared to the control group,with statistical significance(P<0.05).At postoperative 2 days,3 days,and 5 days,the excellent and good rates of sputum clearance in the quantified ACBT group were higher than those in the conventional group,and the difference between the groups was statistically significant,(P<0.05).The VAS score of the quantified ACBT group was slightly higher than that of the conventional group at 2,3,and 5 days after surgery,but there was no statistically significant difference between the groups(P>0.05).The incidence of pulmonary related complications in the quantitative ACBT group was 6.77%,lower than the 18.96%in the conventional group,with a statistically significant difference between the groups(P<0.05).Conclusion For patients undergoing minimally invasive radical esophagectomy for esophageal cancer,postoperative quantitative active respiratory and circulatory training based on inducible spirometry can help with sputum excretion,improve lung function,and reduce the incidence of chest complications.