«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2024年03期

页码:

411-415

栏目:

论著

出版日期:

2024-06-25

文章信息/Info

Title:

Application of occupational therapy in postoperative rehabilitation of patients with non-small cell lung cancer

作者:

白丽丽¹; 江 榆²; 黄亮亮³; 白 莹¹; 张 敏¹

716000 延安,延安市人民医院呼吸与危重症医学科¹、胸外科³
719000 榆林,榆林市中医医院肝病科²

Author(s):

Bai Lili¹;  Jiang Yu²;  Huang Liangliang³;  BAI Ying¹;  Zhang Min¹.

¹Department of Respiratory and Critical Care Medicine, Yan'an People's Hospital, Yan'an, Shaanxi 716000; ²Department of Hepatology, Yulin Hospital of Traditional Chinese Medicine, Shanxi Yulin 719000; ³Department of Thoracic Surgery, Yan'an People's Hospital, Yan'an, Shaanxi 716000

关键词:

非小细胞肺癌;  作业疗法;  功能障碍;  康复医学

Keywords:

Non-small cell lung cancer;  Occupational therapy;  Dysfunction;  Rehabilitation medicine

分类号:

R734.2

DOI:

10.3877/cma.j.issn.1674-6902.2024.03.013

摘要:

目的 分析作业疗法对非小细胞肺癌(non-small cell lung cancer, NSCLC)术后康复的临床疗效。方法 选择2022年11月至2023年11月我院收治的62例NSCLC患者,术后采取常规肺功能康复训练为对照组30例,在对照组基础上采用作业疗法为观察组32例。检测两组治疗前后用力肺活量(the forced vital capacity, FVC)、呼气高峰流量(peak expiratory flow, PEF)、最大通气量(maximal voluntary ventilation, MVV)等肺功能情况; 检测6 min步行距离(6-minute walk distance, 6MWD); 采用日常生活活动量表(activity of daily living, ADL)判断两组生活能力; 统计两组健康行为达标率; 采用肺癌患者生活质量测定量表(functional assessment of cancer therapy-lung, FACT-L)评价两组治疗前后生活质量。结果 观察组治疗前、治疗2个月后、治疗3个月后FVC分别为(1.34±0.19)L、(1.82±0.21)L、(2.36±0.24)L,对照组治疗前、治疗2个月后、治疗3个月后FVC分别为(1.33±0.18)L、(1.39±0.25)L、(1.83±0.22)L,观察组FVC高于对照组(P<0.05); 观察组治疗前、治疗2个月后、治疗3个月后 PEF 分别为(165.28±33.07)L/min 、(195.30±31.27)L/min 、(230.64±38.18)L/min,对照组治疗前、治疗2个月后、治疗3个月后PEF分别为(163.90±30.25)L/min 、(170.25±29.53)L/min 、(194.48±35.03)L/min,观察组PEF高于对照组(P<0.05); 观察组治疗前、治疗2个月后、治疗3个月后 MVV 分别为(47.19±9.92)L、(58.43±10.35)L、(68.19±13.05)L,对照组治疗前、治疗2个月后、治疗3个月后 MVV 分别为(46.02±8.36)L、(50.21±9.27)L、(58.34±11.14)L,观察组MVV高于对照组(P<0.05); 观察组治疗后6MWD(438.83±38.22)m高于对照组(389.36±36.24)m(P<0.05); 观察组治疗后ADL评分(63.65±2.94)分高于对照组(59.83±2.15)分(P<0.05); 观察组治疗后健康行为达标率规范饮食81.25%、适宜运动87.50%、遵医用药84.38%、定期复查90.63%和睡眠休息84.38%高于对照组(63.33%、73.33%、66.67%、76.67%、66.67%)(P<0.05); 观察组治疗后FACT-L评分较对照组改善(P<0.05)。结论 作业疗法可有效提高NSCLC患者术后肺功能康复训练效果,改善生活质量具有临床意义。

Abstract:

Objective To retrospectively analyze the effect of occupational therapy on postoperative rehabilitation of patients with non-small cell lung cancer(NSCLC). Methods A total of 62 patients with NSCLC admitted to our hospital from November 2022 to November 2023 were selected. Among them, 30 patients were treated with routine pulmonary function rehabilitation training after surgery as the control group, and 32 patients were treated with occupational therapy for 3 months on the basis of that as the observation group. The pulmonary function such as forced vital capacity(FVC), peak expiratory flow(PEF)and maximum ventilation(MVV)were detected before and after treatment in the two groups. The 6-minute walking distance(6MWD)was measured. The activities of daily living scale(ADL)was used to evaluate the living ability of the two groups. The compliance rate of health behavior of the two groups was counted. Functional Assessment of Cancer Therapy-Lung(FACT-L)was used to evaluate the quality of life of the two groups before and after treatment. Result The FVC of the observation group before treatment, 2 months after treatment and 3 months after treatment were(1.34±0.19)L,(1.82±0.21)L and(2.36±0.24)L, respectively. The FVC of the control group before treatment, 2 months after treatment and 3 months after treatment were(1.33±0.18)L,(1.39±0.25)L and(1.83±0.22)L, respectively. The FVC of the observation group was higher than that of the control group(P<0.05). The PEF of the observation group before treatment, 2 months after treatment and 3 months after treatment were(165.28±33.07)L/min,(195.30±31.27)L/min and(230.64±38.18)L/min, respectively. The PEF of the control group before treatment, 2 months after treatment and 3 months after treatment were(163.90±30.25)L/min,(170.25±29.53)L/min and(194.48±35.03)L/min, respectively. The PEF of the observation group was higher than that of the control group(P<0.05). The MVV of the observation group before treatment, 2 months after treatment and 3 months after treatment were(47.19±9.92)L,(58.43±10.35)L and(68.19±13.05)L, respectively. The MVV of the control group before treatment, 2 months after treatment and 3 months after treatment were(46.02±8.36)L,(50.21±9.27)L and(58.34±11.14)L, respectively. The MVV of the observation group was higher than that of the control group(P<0.05). After treatment, the 6MWD of the observation group(438.83±38.22)m was significantly higher than that of the control group(389.36±36.24)m(P<0.05); After treatment, the ADL score of the observation group(63.65±2.94)was significantly higher than that of the control group(59.83±2.15), P<0.05; After treatment, the compliance rate of health behavior in the observation group(81.25%, 87.50%, 84.38%, 90.63%, 84.38%)was significantly higher than that in the control group(63.33%, 73.33%, 66.67%, 76.67%, 66.67%), P<0.05. After treatment, the FACT-L score of the observation group was significantly improved compared with the control group(P<0.05). Conclusion Occupational therapy can effectively improve the effect of postoperative pulmonary function rehabilitation training in patients with NSCLC and improve the quality of life of patients, which has certain clinical promotion value.

参考文献/References:

1 Lozano MD, Argueta A, de Andrea C. Immunotherapy and lung cytopathology: Overview and possibilities[J]. Cytopathology, 2024, 35(2): 213-217.
2 Mourino N, Varela-Lema L, Ruano-Ravina A, et al. Occupational exposure to endotoxins and small cell lung cancer: a systematic review with meta-analysis[J]. J Toxicol Environ Health B Crit Rev, 2024, 27(3): 91-105.
3 Zhu L, Gao R, Li H, et al. Are immune checkpoint inhibitors safe and effective in lung cancer patients with pre-existing interstitial lung disease?[J]. Immunotherapy, 2024, 16(7): 465-480.
4 吴国明, 钱桂生. 非小细胞肺癌靶向治疗研究进展及新理念[J/CD]. 中华肺部疾病杂志(电子版),2019,12(4):405-408.
5 Huang Z, Xiao Z, Yu L, et al. Tumor-associated macrophages in non-small-cell lung cancer: from treatment resistance mechanisms to therapeutic targets[J]. Crit Rev Oncol Hematol, 2024: 104284.
6 Sharma VS, Yadav V. Effect of prehabilitation in lung cancer patients undergoing lobectomy: A review [J]. Cureus, 2023, 15(12): e49940.
7 Voorn MJJ, Driessen EJM, Reinders R, et al. Effects of exercise prehabilitation and/or rehabilitation on health-related quality of life and fatigue in patients with non-small cell lung cancer undergoing surgery: A systematic review[J]. Eur J Surg Oncol, 2023, 49(10): 106909.
8 Reid H, Hocking C, Smythe E. Occupational therapy's oversight: How science veiled our humanity[J]. Scand J Occup Ther, 2024, 31(1): 2306585.
9 Schwartz J, Proffitt R. Cautioning the role of occupational therapy in addressing obesity[J]. Am J Occup Ther, 2024, 78(2): 7802050010.
10 王 瑞, 姚 烽, 陈春基, 等.《中华医学会肺癌临床诊疗指南(2019版)》外科治疗解读[J]. 中国胸心血管外科临床杂志, 2020, 27(11): 1265-1268.
11 韩 睿, 林洪生. 健身气功八段锦对非小细胞肺癌术后患者肺功能及生存质量干预疗效的临床研究[J]. 天津中医药, 2016, 33(12): 715-718.
12 周莉娅, 杨晓静. 肺功能康复训练对非小细胞肺癌术后化疗患者的康复效果[J]. 临床医学, 2023, 43(10): 80-82.
13 李建军, 郑 婧. 肺康复训练联合个体化营养干预对非小细胞肺癌患者术后康复的影响[J]. 重庆医学, 2023, 52(10): 1515-1519.
14 傅兆庆. 补肺活血汤促进非小细胞肺癌患者术后快速康复的临床研究[D]. 山东大学, 2023: 23-46.
15 苏晓宁, 郑建清, 陈 樱. SF-36量表和EORTC QLQ-LC43量表在肺癌患者生活质量测定中的应用效果[J]. 中国卫生标准管理, 2023, 14(9): 114-120.
16 吴珊珊. 健康教育联合心理护理对肺癌患者癌性疼痛及生活质量的影响分析[J]. 实用中西医结合临床, 2021, 21(15): 147-148.
17 Judkins JL, Nguyen VT, Richardson MD, et al. Association between availability of direct access to army occupational therapy with return to duty in active-duty soldiers[J]. J Hand Ther, 2024, doi: 10.1016/j.jht.2023.12.007.
18 Cogan AM, Haltom TM, Shimada SL, et al. Understanding patients'experiences during transitions from one electronic health record to another: A scoping review[J]. PEC Innov, 2024, 4: 100258.
19 Dostie R, Dunn H, Marks WN, et al. Use of telehealth for paediatric rehabilitation needs of Indigenous children-a scoping review[J]. Int J Circumpolar Health, 2024, 83(1): 2308944.
20 王 璐, 单守勤. 作业疗法在颅脑损伤患者上肢功能恢复中的作用观察[J]. 中国疗养医学, 2015, 24(1): 58-59.
21 朱卫娟. 作业疗法在脑卒中患者康复中的效果探讨[J]. 中国实用医药, 2023, 18(15): 164-167.
22 Maurer J, Friedemann T, Chen Y, et al. A randomized controlled study on acupuncture for peri-operative pain after open radical prostatectomy[J]. BJU Int, 2024: 725-732.
23 Georges O, Abou Arab O, Ben Rahal M, et al. Diagnostic value of systematic bronchial aspirate on postoperative pneumonia after pulmonary resection surgery for lung cancer: a Mono center retrospective study[J]. Interdiscip Cardiovasc Thorac Surg, 2024, 38(2): ivad212.
24 Huang H, Liu B, Chen M, et al. Treatment of non-small cell lung cancer with Yiqi Buxue prescriptions combined with adjuvant chemotherapy on the cancer therapy-related cardiovascular toxicity: A systematic review and meta-analysis[J]. J Ethnopharmacol, 2024, 323: 117665.
25 Munambah N, Ramugondo EL, Collins T, et al. Seeking consensus on a play-based intervention framework for promoting play of children with HIV/Aids in a low-resourced setting: A Delphi study[J]. Aust Occup Ther J, 2024, doi: 10.1111/1440-1630.12936.
26 Henderson R, Lakshmanan R, McLaughlin A, et al. A complicated Chiari type 1 malformation and holocord syrinx as a likely cause for heel pain[J]. Childs Nerv Syst, 2024, 40(4): 997-1003.
27 Flores LE, Westmark D, Katz NB, et al. Prehabilitation in radiation therapy: a scoping review[J]. Support Care Cancer, 2024, 32(1): 83.
28 Mishra AK, Varma AR. A Comprehensive Review of the Generalized Anxiety Disorder[J]. Cureus, 2023, 15(9): e46115.
29 Lu Y, Bai X, Pan C. Impact of exercise interventions on quality of life and depression in lung cancer patients: A systematic review and meta-analysis[J]. Int J Psychiatry Med, 2024, 59(2): 199-217.
30 O'Brien K, Zhang B, Anderl E, et al. Special Considerations in Behavioral Assessments for Disorders of Consciousness [J]. Phys Med Rehabil Clin N Am, 2024, 35(1): 93-108.

备注/Memo

备注/Memo:

基金项目: 陕西省科技厅的项目(2018JQ3073)
通信作者: 江 榆, Email: 632104973@qq.com

常用功能

更新日期/Last Update: 2024-06-25