Effect of continuous nursing combined with respiratory exercise nursing on pulmonary function of postoperative patients with lung cancer

BACKGROUND Lung cancer is a malignant tumor with high morbidity and mortality among cancers.Surgery is currently one of the primary methods of treating lung cancer.Although it can slow down the progression of the disease by removing the lesion,this invasive surgery inevitably damages the integrity of the patient’s chest.Moreover,the patient’s pulmonary function may have a low compensatory capacity after surgery,causing various respiratory diseases such as atelectasis,respiratory function decline,and even serious cardiovascular disease.All of these have great negative impacts on the surgical effect and the prognosis of patients.With the continuous exploration and development of nursing,continuous nursing and respiratory exercise nursing have been gradually applied in the nursing of patients after lung cancer surgery,and have achieved good nursing results.AIM To investigate the effect of continuous nursing combined with respiratory exercise nursing on the pulmonary function of postoperative patients with lung cancer.METHODS A total of 80 patients with lung cancer who underwent surgery in our hospital from January 2021 to December 2021 were selected as the study subjects.All subjects were randomly divided into the control group(n=40 cases)and the experimental group(n=40 cases).Patients with lung cancer in the control group were given conventional nursing after surgery,while the experimental group was given continuous nursing combined with respiratory exercise nursing based on conventional nursing.The recovery of pulmonary function and respiratory symptoms was observed before and after 3 mo of intervention in both groups.The pulmonary function parameters,blood gas analysis,MD Anderson Symptom Inventory-lung cancer module(MDASI-LC)scores,incidence of pulmonary complications,and Morisky compliance scores were compared between the two groups before and after 3 mo of intervention.RESULTS There was no significant difference in pulmonary function and blood gas analysis between the two groups before intervention(P>0.05).3 mo after the intervention,the pulmonary function parameters in the experimental group(SpO2,VC,MVV,FEV1,FEV1%pred,and FEV1/FVC)were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in blood gas analysis between the two groups before intervention(P>0.05).PaO2 in the experimental group was significantly higher than that in the control group,and PaCO_(2) was significantly lower than that in the control group 3 mo after the intervention.The difference had statistical significance(P<0.05).3 mo after the intervention,the MDASI score of respiratory symptoms in the experimental group was significantly lower than that in the control group(P<0.05),and the incidence of pulmonary complications was lower than that in the control group(P<0.05).In addition,the treatment compliance and nursing satisfaction of patients in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).CONCLUSION Continuous nursing combined with respiratory exercise nursing can significantly accelerate the recovery of respiratory function in postoperative lung cancer patients,reduce the incidence of postoperative complications of lung cancer as well as improve the treatment compliance of patients.

Effectiveness of oral motor respiratory exercise and vocal intonation therapy on respiratory function and vocal quality in patients with spinal cord injury:a randomized controlled trial

Singing,as a method of combining respiratory function exercise and vocal intonation therapy,provides a new direction for respiratory function exercise in patients with spinal cord injury.This randomized controlled trial investigated the effects of oral motor respiratory exercise and vocal intonation therapy on respiratory function and vocal quality in patients with spinal cord injury.Among 31 included patients with spinal cord injury,18 completed the treatment.These 18 patients were randomly assigned to undergo music therapy(intervention group,30 min/d,5 times a week,for a total of 12 weeks;n=9,7 males and 2 females;30.33±11.74 years old)or normal respiratory training(control group,n=9;8 males and 1 female;34.78±11.13 years old).Both patient groups received routine treatment concurrently.Before and at 6 and 12 weeks after intervention,a standard respiratory function test,a voice test,the St.George's Respiratory Questionnaire,and a quality of life questionnaire were administered.The results showed that the inspiratory capacity,forced expiratory volume in 1 second,forced vital capacity,maximal mid-expiratory flow rate,sing-loud pressure level,and sustained note length were significantly increased in the intervention group compared with the control group.The St.George's Respiratory Questionnaire and quality of life results of patients in the intervention group were significantly superior to those in the control group.These findings suggest that oral motor respiratory exercise and vocal intonation therapy,as respiratory training methods in music therapy,are effective and valuable for improving respiratory dysfunction and vocal quality in patients with spinal cord injury.This study was approved by the Ethics Committee of China Rehabilitation Research Center(approval No.2019-78-1)on May 27,2019 and was registered with the Chinese Clinical Trial Registry(registration number:Chi CTR1900026922)on October 26,2019.

CORRELATIONS BETWEEN OXY-HEMOGLOBIN AND RESPIRATORY EXCHANGE RATIO IN THE QUADRICEPS DURING THE EARLY PHASE OF EXERCISES

The early stage of exercises is crucial in sports training;however,its physiological mechanism is still unclear.The hemodynamic response was reported to be associated with respiratory exchange.Here,we aimed to explore the relationship between oxy-hemoglobin concentration change(HbO_(2))and respiratory exchange ratio(RER)during the early phase of exercises.Sixteen athletes of middle-distance race were selected from Wuhan Institute of Physical Education to conduct intermittent exercises on MERCURY4.0 at 80%VO_(2)peak intensity.Multiple physiological parameters were acquired by use of a near-infrared spectroscopy muscle oxygen monitor,a Cardiopulmonary Function MAX-II and a P-Lar,including HbO_(2),RER and others.A significant correlation was found between RER and HbO_(2)in quadriceps muscle in the thigh during the early phase of exercises.Thus,NIRS is capable of supervising sports training in terms of HbO_(2),which actually acted as an interpreter of RER change.

Effects of Video Combined with the Teach-Back Method on the Respiratory Function Exercise of Patients Undergoing Thoracotomy

Objective: To explore the effect of video combined with the teach-back method on respiratory function exercise in patients undergoing tumor thoracotomy. Methods: Eligible patients undergoing thoracotomy for tumor were selected from the thoracic surgery at a level-A tertiary hospital between August 2021 and December 2021 and included in the control group and the observation group (40 patients in each group). To prevent two groups of patients from interacting with each other, the thoracic surgery ward I was distinguished as the control group, which was adopted by the routine instruction. Based on routine instruction, the thoracic surgery ward II conducted respiratory function exercise instruction by video combined with the teach-back method to compare the two groups’ compliance with respiratory function exercise, complication rates, and patient satisfaction. Results: The patient compliance with respiratory function exercise in the observation group was significantly higher (P < 0.05) and the rate of pulmonary complications in the observation group was lower (P < 0.05) than that in the control group, while the observation group had a high level of satisfaction (P Conclusion: Taking video combined with the teach-back method, an effective health education method, can improve the compliance of the respiratory function exercise of patients undergoing thoracotomy for tumor and promote the recovery of pulmonary function to reduce the incidence of postoperative pulmonary complications so as to improve patient satisfaction.

Effects of respiratory muscle training on post-stroke rehabilitation:A systematic review and meta-analysis

BACKGROUND Stroke often results in significant respiratory dysfunction in patients.Respiratory muscle training(RMT)has been proposed as a rehabilitative intervention to address these challenges,but its effectiveness compared to routine training remains debated.This systematic review and meta-analysis aim to evaluate the effects of RMT on exercise tolerance,muscle strength,and pulmonary function in post-stroke patients.AIM To systematically assess the efficacy of RMT in improving exercise tolerance,respiratory muscle strength,and pulmonary function in patients recovering from a stroke,and to evaluate whether RMT offers a significant advantage over routine training modalities in enhancing these critical health outcomes in the post-stroke population.METHODS Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines,a comprehensive search across PubMed,Embase,Web of Science,and the Cochrane Library was conducted on October 19,2023,without temporal restrictions.Studies were selected based on the predefined inclusion and exclusion criteria focusing on various forms of RMT,control groups,and outcome measures[including forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximal voluntary ventilation(MVV),peak expiratory flow(PEF),maximal inspiratory pressure(MIP),maximal expiratory pressure(MEP),and 6-min walking test(6MWT)].Only randomized controlled trials(RCTs)were included.Data extraction and quality assessment were conducted independently by two reviewers using the Cochrane Collaboration's risk of bias tool.Statistical analyses,including those using the fixed-effect and random-effects models,sensitivity analysis,and publication bias assessment,were performed using Review Manager software.RESULTS A total of 15 RCTs were included.Results indicated significant improvements in MIP(12.51 cmH2O increase),MEP(6.24 cmH2O increase),and various pulmonary function parameters(including FEV1,FVC,MVV,and PEF).A substantial increase in 6MWT distance(22.26 meters)was also noted.However,the heterogeneity among studies was variable,and no significant publication bias was detected.CONCLUSION RMT significantly enhances walking ability,respiratory muscle strength(MIP and MEP),and key pulmonary function parameters(FEV1,FVC,MVV,and PEF)in post-stroke patients.These findings support the incorporation of RMT into post-stroke rehabilitative protocols.

Investigating the circulatory-respiratory response of elderly people during Tai Chi Yuttari-exercise

The purpose of this study was to examine the circulatory-respiratory dynamics in elderly people during Tai Chi Yuttari-exercise. The subjects were females with an average age of 74 years who had been continuously practicing Tai Chi Yuttari-exercise for at least six months. The heart rate and blood pressure were measured before and after the subjects performed four different versions of Tai Chi Yuttari-exercise. The perceived exertion was evaluated using the Borg scale. The respiratory rate, oxygen uptake and respiratory quotient (RQ) were measured using an expired gas analyzer. The results showed an increase in heart rate during exercise, but confirmed that the rise in HR was below the safety limit. The blood pressure tended to be low post-exercise. Regarding perceived exertion, the maximum heart-lungs Borg scale response was 9 (very light). A slight increase in the respiratory rate was observed while exercising, but no abnormal breathing patterns were observed. The average metabolic equivalents (METs) of the exercise ranged from 1.34 to 1.87, and the average RQ ranged from 0.82 to 0.90. The circulatory-respiratory dynamics observed in this study verified that elderly females with an average age of 70 years could safely perform the Tai Chi Yuttari-exercise. This study helped obtain basic data for expanding the indications for this exercise.

Efficacy of Liuzijue respiratory exercise in patients with chronic obstructive pulmonary disease:a meta-analysis

Objective:To evaluate the effects of Liuzijue respiratory exercise in patients with chronic obstructive pulmonary disease(COPD).Method:Randomly controlled trials of Liuzijue respiratory exercise in the treatment of COPD were searched in the database,including PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang,CBM,and VIP.Study screening,data extraction,and quality assessment were conducted by two researchers independently.Data were analyzed using RevMan 5.3 software.Results:11 studies with 915 COPD patients were included.Results of meta-analysis showed that compared with conventional care,Liuzijue respiratory exercise had shown better effects on FEV1(Forced expiratory volume in 1 second)[MD=0.18,95%CI(0.06,0.30),P=0.004],FEV1%pred[MD=10.21,95%CI(7.25,13.18),P<0.001],FEV1/FVC%(Forced vital capacity)[MD=8.32,95%CI(3.23,13.40),P<0.001],6-minute walk distance[MD=10.97,95%CI(5.81,16.12),P<0.001]and life quality[MD=-10.07,95%CI(-12.84,-7.30),P<0.001].However,no difference was observed in the effective rate between these two groups.Compared with whole body respiratory exercise,except for the better effects on 6-minute walk distance[MD=37.82,95%CI(6.51,69.13),P=0.02],no difference in FEV1,FEV1%pred,FEV1/FVC%and life quality were observed between these two groups.Conclusion:Liuzijue respiratory exercise can better improve lung function,functional capacity,and life quality of COPD patients compared with conventional care.Compared with the whole body respiratory exercise,Liuzijue could improve the functional capacity of COPD patients significantly and showed similar effcets on lung function and life quality.

Demystifying roles of exercise in immune response regulation against acute respiratory infections:A narrative review

The benefits of physical activity and exercise,especially those classified as moderate-to-vigorous activity(MVPA),have been well-established in preventing non-communicable diseases and mental health problems in healthy adults.However,the relationship between physical activity and exercise and the prevention and management of acute respiratory infection(ARI),a global high-burden disease,has been inconclusive.There have been debates and disagreements among scientific publications regarding the relationship between exercise and immune response against the causative agents of ARI.This narrative review aims to explore the theory that sufficiently explains the correlation between exercise,immune response,and ARI.The potential root causes of discrepancies come from research associated with the“open window”hypothesis.The studies have several limitations,and future improvements to address them are urgently needed in the study design,data collection,exercise intervention,subject recruitment,biomarkers for infection and inflammation,nutritional and metabolism status,and in addressing confounding variables.In conclusion,data support the clinical advantages of exercise have a regulatory contribution toward improving the immune response,which in turn potentially protects humans fromARI.However,the hypothesis related to its negative effect must be adopted cautiously.

Exercise manual for liver disease patients

AIM: To increase inspiratory muscle strength and improve the quality of life of candidates for liver transplantation.METHODS: Twenty-three candidates for liver transplantation participated in the control group and 14 made up the intervention group. The control group consisted of 18 men and 5 women, body mass index(BMI) 27.3 ± 4.5 kg/m2 and Model for End-Stage Liver Disease(MELD) 18.2 ± 6.1. The intervention group consisted of 11 men and 3 women, BMI 28.6 ± 5.4 kg/m2 and MELD 18 ± 4.5. The presence or absence of ascites was identified in the first patient evaluation and after three months. We evaluated maximal inspiratory pressure(MIP) and maximal expiratory pressure, spirometry, root mean square(RMS) of diaphragm and rectus abdominis, and the quality of life. The exercises were performed daily by patients at home for three months and were supervised at distance monthly. The manual consisted of diaphragmatic breathing exercises, diaphragmatic isometric exercise, Threshold IMT&#174;, lifting upper limbs with a bat and strengthening the abdomen. RESULTS: There was significant difference(P = 0.01) between the first(initial) and the third month(final) MIP in the control group and in the intervention group, but there was no difference(P = 0.45) between the groups.The RMS of the diaphragm was lower(P = 0.001) and the functional capacity was higher(P = 0.006) in the intervention group compared to the control. The general health and mental health domains received higher scores after three months in the control group(P = 0.01) and the intervention group(P = 0.004), but there was no significant difference between them. The comparison between the presence of initial ascites with the presence of ascites was performed after three months in the control group(P = 0.083) and intervention group(P = 0.31). There was no significant difference, in relation to the presence of ascites after three months between groups(P = 0.21). In the intervention group, patients with ascites at the end of the time period had decreased scores on the social aspects SF-36 domain(P = 0.023) compared to those who had no ascites. CONCLUSION: The proposed exercises provide an increase in the inspiratory muscle strength and improve functional capacity, consequently bettering the quality of life of liver disease patients.

Too hard to die:Exercise training mediates specific and immediate SARS-CoV-2 protection

Several mechanisms may explain how exercise training mechanistically confers protection against coronavirus disease 2019(COVID-19).Here we propose two new perspectives through which cardiorespiratory fitness may protect against severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).Physical exercise-activated adenosine monophosphate(AMP)-activated protein kinase(AMPK)signaling induces endothelial nitric oxide(NO)synthase(eNOS),increases NO bio-availability,and inhibits palmitoylation,leading to specific and immediate SARS-CoV-2 protection.AMPK signaling also induces angiotensin 1-7 release and enhances eNOS activation thus further mediating cardio-and renoprotection.Irisin,a myokine released from skeletal muscles during aerobic exercise,also participates in the AMPK/Akt-eNOS/NO pathway,protects mitochondrial functions in endothelial cells,and antagonizes renin angiotensin system proinflammatory action leading to reductions in genes associated with severe COVID-19 outcomes.Collectively,all the above findings point to the fact that increased AMPK and irisin activity through exercise training greatly benefits molecular processes that mediate specific,immediate,and delayed SARS-CoV-2 protection.Maintaining regular physical activity levels is a safe and affordable lifestyle strategy against the current and future pandemics and may also mitigate against obesity and cardiometabolic disease syndemics.Move more because a moving target is harder to kill.

远程医疗管理在老年中重度慢性阻塞性肺疾病患者稳定期呼吸康复中的效果:一项随机对照研究

背景我国慢性阻塞性肺疾病(COPD)患者数量巨大,呼吸康复训练作为COPD患者稳定期管理的重要部分,可有效提高患者肺功能及生活质量,减少家庭及社会负担,国外有研究数据显示远程医疗管理下实施呼吸康复可提高患者的肺功能和生活质量(QOL)评分,但是国内,尤其是西部尚缺乏相关实践。目的评估通过远程医疗管理进行呼吸康复训练与传统治疗相结合对老年中重度COPD患者通气能力及肺功能的影响。方法本研究为前瞻性随机对照研究,连续性纳入2021年6月—2022年6月就诊于四川省第四人民医院及5个联合社区的COPD患者,采用随机数字表进行简单随机分组,将患者分为试验组和对照组。对照组接受传统的长期规律吸入支气管扩张剂及口服药物治疗,试验组在对照组治疗方案的基础上采用远程医疗管理。对两组患者进行为期6个月的研究,分别在基线时及干预1、3、6个月后记录患者的肺功能、博格评分(Borg评分)、6 min步行试验(6MWT)、QOL评分。结果研究对象分为对照组(72例)和试验组(73例),两组患者的性别、年龄及基线时肺功能[第1秒用力呼气末容积占预计值百分比(FEV_(1)%pred)及第1秒用力呼气末容积与用力肺活量(FVC)的比值(FEV_(1)/FVC)]比较,差异均无统计学意义(P>0.05)。时间和组间对FEV_(1)%pred、FEV_(1)/FVC、6MWT水平、QOL评分中呼吸困难、情绪存在交互作用(P<0.05)。干预1、3、6个月后,试验组FEV_(1)%pred、FEV_(1)/FVC、Borg评分、6MWT、QOL评分优于对照组(P<0.05);干预3、6个月后,试验组FEV_(1)%pred、FEV_(1)/FVC、Borg评分、6MWT、QOL评分优于干预后1个月时(P<0.05)。结论采用远程医疗管理对老年中重度COPD稳定期患者进行呼吸康复,干预3、6个月后能有效改善该类患者肺功能,提高生活质量及生存质量。

多形式健康教育模式联合简易呼吸功能锻炼对老年肺癌放疗病人癌因性疲乏及遵医行为的影响

目的 探究老年肺癌放疗病人接受多形式健康教育模式联合简易呼吸功能锻炼的效果。方法 选取本院于2021年3月至2023年9月收治的60例肺癌放疗病人进行前瞻性研究,按照随机数表法分为研究组(30例)与对照组(30例),对照组接受常规护理干预,研究组接受多形式健康教育模式联合简易呼吸功能锻炼干预,比较2组干预前后癌因性疲乏[Piper疲乏量表(PFS)评分]、生活质量[生活质量核心问卷(QLQ-C30)评分]、呼吸功能[呼出气一氧化氮(FeNO)、呼吸频率及氧合指数]、遵医行为、护理满意度(病人护理需求及满意程度调查表)情况。结果 干预前,2组PFS、QLQ-C30评分,FeNO、呼吸频率、氧合指数水平比较,差异无统计学意义(P>0.05);干预后,2组上述指标均有改善,差异有统计学意义(P<0.05),且研究组PFS评分、FeNO水平和呼吸频率低于对照组,QLQ-C30评分和氧合指数高于对照组,差异有统计学意义(P<0.05);护理期间,研究组的遵医率及护理干预满意度评分均高于对照组,差异有统计学意义(P<0.05)。结论 对老年肺癌放疗病人采取多形式健康教育模式联合简易呼吸功能锻炼干预,能够显著改善其癌因性疲乏,提高老年病人遵医性与生活质量,提升其对护理干预的满意度,具有较好的临床应用价值。

信息-动机-行为技巧(IMB)呼吸锻炼对肺癌患者心理状态、自我管理和术后适应能力的影响

目的:探讨基于信息-动机-行为技巧(IMB)模型理论制定的呼吸功能锻炼干预措施对老年肺癌手术患者心理状态、自我管理能力以及术后适应情况的影响。方法:便利抽样法,选取2021年1月至2022年1月于某医院胸外科收治的100例老年肺癌手术患者,按随机数字表法分为对照组和研究组,每组各50例,对照组予以常规呼吸功能锻炼干预,研究组基于IMB模型理论进行呼吸功能锻炼干预。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、心理弹性量表(CD-RISC)、呼吸功能锻炼依从性问卷、肺癌手术患者术后适应状况调查问卷评估两组患者负性情绪、心理弹性、术后自我管理能力与适应情况。结果:干预后,相比较于对照组,研究组SAS、SDS评分均降低(t=-5.155,-8.465;P<0.05),CD-RISC评分、呼吸功能锻炼依从性评分、术后适应情况评分均升高(t=6.255,23.776,10.712;P<0.05)。结论:IMB模型的呼吸功能锻炼干预可以改善老年肺癌手术患者负性情绪,增强其心理弹性、自我管理和术后适应能力。

基于CPET试验的呼吸康复训练在慢性肺源性心脏病合并心力衰竭患者中的应用效果

目的分析基于心肺运动试验(CPET)的呼吸康复训练在肺源性心脏病(简称肺心病)合并心力衰竭患者中的应用效果。方法选取昆山市第六人民医院、昆山市中医院2021年8月—2023年10月收治的60例慢性肺心病合并心力衰竭患者为研究对象,根据随机数字表法将其分为对照组和研究组。对照组(n=30)采用常规康复训练,研究组(n=30)采用基于CPET试验的呼吸康复训练。比较两组患者的心功能、肺功能、生活质量。结果干预前,两组左室射血分数(LVEF)、左心室舒张末期内径(LVDD)、6 min步行距离(6MWD)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)比较,组间差异无统计学意义(P<0.05);干预后,研究组LVEF、FVC、FEV1均大于对照组,6MWD长于对照组,LVDD小于对照组,组间差异有统计学意义(P<0.05)。干预前,两组欧洲五维生存质量量表(EQ-5D)健康描述与EQ-VAS评分比较,组间差异无统计学意义(P>0.05);干预后,研究组EQ-5D健康描述评分为(4.86±0.88)分,低于对照组的(6.33±0.92)分,EQ-VAS评分为(77.36±6.26)分,高于对照组的(66.23±6.18)分,组间差异有统计学意义(P<0.05)。结论将以CPET试验为支持的呼吸康复训练方法应用于肺心病合并心力衰竭患者,能有效改善患者的心功能、肺功能,提高生活质量。

赋权激励教育护理结合呼吸运动康复训练对稳定期慢性阻塞性肺疾病患者的影响

目的探讨赋权激励教育护理结合呼吸运动康复训练对稳定期慢性阻塞性肺疾病(COPD)患者的影响.方法选择2021年6月—2023年8月潍坊市人民医院收治的82例稳定期COPD患者为研究对象.按随机数字表法将患者分为对照组和观察组,各41例.对照组行常规护理干预,观察组行赋权激励教育护理结合呼吸运动康复训练干预.比较两组康复依从性、肺功能及生活质量.结果观察组康复依从性高于对照组,差异有统计学意义(P<0.05).干预后,观察组第1秒用力呼气量为(2.38±0.59)L,用力肺活量为(1.58±0.41)L,最大呼气流量为(197.62±19.85)L/s,均大于对照组的(2.06±0.51)L、(1.26±0.37)L、(184.25±19.63)L/s,圣乔治呼吸问卷评分低于对照组,组间差异有统计学意义(P<0.05).结论赋权激励教育护理结合呼吸运动康复训练应用于稳定期COPD患者中,可增强患者康复依从性,提高生存质量,改善肺功能.

慢性阻塞性肺疾病患者“4S”肺康复运动护理指导的临床观察

目的:探究“4S”肺康复运动护理指导训练在慢性阻塞性肺疾病(COPD)稳定期患者中的应用效果。方法:通过回顾性分析并选取2019年10月—2021年10月160例于襄阳市襄州区人民医院呼吸与危重症医学科住院的COPD稳定期患者,并将其随机划分成观察组和对照组,各80例。观察组接受常规治疗和“4S”肺康复运动护理指导,对照组接受常规治疗和普通康复锻炼。比较两组第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积占用力肺活量的百分比(FEV_(1)/FVC%)、6 min步行距离(6MWD)、圣乔治呼吸问卷(SGRQ)、改良呼吸困难指数(mMRC)及慢性阻塞性肺疾病评估测试(CAT)评分。结果:干预后,两组肺部功能较干预前均提高,且观察组的FEV_(1)和FEV_(1)/FVC%均明显高于对照组,差异均有统计学意义(P<0.05)。干预后,观察组6MWD、SGRQ评分均较干预前改善,较对照组均改善明显,差异均有统计学意义(P<0.05)。干预后,观察组mMRC、CAT评分均比对照组更优,差异均有统计学意义(P<0.05)。结论:“4S”肺康复运动护理指导可以显著改善患者的呼吸困难症状,提升肺功能,增强运动的适应力。总之,在规范治疗慢阻肺的基础上实施“4S”肺康复运动护理指导能明显提升稳定期慢阻肺患者的治疗效果。

围手术期肺癌患者呼吸功能锻炼的最佳证据总结

目的运用循证方法整合围手术期肺癌患者呼吸功能锻炼的最佳证据。方法系统检索中英文数据库和指南网站中有关围手术期肺癌患者呼吸功能锻炼的相关证据,检索时限为建库至2023年11月8日。由两名研究者对符合标准的文献进行质量评价,独立逐篇阅读,逐条提取证据内容,并根据主题共同整理与归纳证据。结果共纳入21篇文献,包括指南2篇、专家共识3篇、系统评价11篇、临床决策1篇、证据总结4篇。最终从评估、多学科协作团队、锻炼原则、锻炼方式、呼吸锻炼方案、监督管理、效果监测、注意事项8个方面共总结出25条最佳证据。结论研究归纳整合的国内外围手术期肺癌患者呼吸功能锻炼最佳证据有益于临床护理实践,可推广应用。

踏车训练和呼吸训练对维持性血液透析患者运动耐力、肺功能及生存质量的影响

目的:评估和比较踏车训练和呼吸训练对维持性血液透析(maintenance hemodialysis,MHD)患者运动耐力、肺功能及生存质量的影响。方法:2022年7月—2023年7月,本院60例MHD患者采用随机数字表法分为对照组(n=20)、踏车组(n=20)、呼吸组(n=20)。对照组给予常规血液透析治疗。踏车组在常规血液透析治疗基础上给予中等强度的透析中踏车训练共12周,每周3次,每次时间40min。呼吸组在常规血液透析治疗基础上给予呼吸训练(腹式呼吸训练、缩唇呼吸训练以及膈肌呼吸训练)共12周,每周3次,每次时间40min。分别于治疗前和治疗后对患者进行评估,采用峰值摄氧量(VO_(2peak))、无氧阈(AT)、峰值氧脉搏(VO_(2)/HR_(peak))评估患者的运动耐力,用力肺活量(FVC)、第一秒用力呼气量(FEV1)、每分钟最大通气量(MVV)评估患者的肺功能,肺功能指标以实测值占预计值的百分比表示,即FVC%、FEV1%、MVV%。采用健康调查简表(the MOS item short from health survey,SF-36)评估患者的生存质量,包括生理健康(PCS)、精神健康(MCS)、总分。结果:治疗前,3组患者的VO_(2peak)、AT、VO_(2)/HR_(peak)、FVC%、FEV1%、MVV%、PCS、MCS及总分均无明显差异(P>0.05);治疗12周后,踏车组VO_(2peak)、AT、VO_(2)/HR_(peak)、PCS、总分较本组治疗前增加且优于对照组(P<0.05);呼吸组FVC%、FEV1%、MCS、总分较本组治疗前增加且优于对照组(P<0.05)。结论:踏车训练和呼吸训练均能改善MHD患者的心肺功能及生存质量,其中踏车训练在提高运动耐力及生理健康方面疗效更显著,呼吸训练在提高肺功能及精神健康方面疗效更显著。

非小细胞肺癌患者围术期运动方案的应用效果评价

目的:评价非小细胞肺癌患者围术期运动方案的应用效果。方法:通过便利抽样法,选取2022年2月至12月就诊于安徽省医科大学第一附属医院的非小细胞肺癌患者为研究对象,按照入院时间进行分组,对照组给予围术期常规护理,干预组在围术期常规护理的基础上,应用本课题组前期构建的非小细胞肺癌患者围术期运动方案,通过主要结局指标(肺功能、运动耐力、术后早期并发症)、次要结局指标(症状测评、肺癌患者运动自我效能、术后胸腔闭式引流管的留置时间、住院时间)及安全性指标(不良事件发生率)来评价非小细胞肺癌患者围术期运动干预方案的应用效果。结果:共纳入166例非小细胞肺癌患者,对照组88例,干预组78例,出院当天干预组肺功能、6min步行距离、运动自我效能均高于对照组,症状得分低于对照组(P<0.05)。但两组术后早期并发症发生率、带管时间和住院时间差异无显著性意义(P>0.05)。在整个围术期,两组均未发生与运动相关的不良事件。结论:非小细胞肺癌患者围术期运动方案是安全有效的,有助于促进非小细胞肺癌患者术后肺功能、运动耐力的恢复,改善患者术后症状,提高患者运动自我效能。

早期运动联合呼吸康复在心肾联合移植中的应用

目的总结早期运动联合呼吸康复在心肾联合移植中的应用2例,为心肾联合移植受者行早期运动联合呼吸康复提供临床实践理论。方法选取2020年11月至2021年3月在广西医科大学第二附属医院移植医学中心行心肾联合移植后进行早期运动联合呼吸康复受者临床资料,采用病例回顾性分析,收集受者临床及随访资料,分析受者焦虑抑郁评分、肌力评分、营养评分、血栓评分、血气分析指标及术后随访肺部感染指标。结果2例心肾联合移植行早期运动联合呼吸康复受者,术后焦虑及抑郁评分明显下降,术后肌力、营养及血栓评分明显改善,受者动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))、血氧饱和度(arterial oxygen saturation,SaO_(2))升高,动脉血二氧化碳分压(partial pressure of carbon dioxide,PaCO_(2))降低,随访2年未出现肺部感染。结论早期运动联合呼吸康复可改善心肾联合受者心理状态,改善受者血气分析指标,提高受者运动耐力,为心肾联合移植实施早期运动联合呼吸康复提供临床实践理论指导。