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

卷:

期数:

2025年02期

页码:

295-299

栏目:

论著

出版日期:

2025-04-25

文章信息/Info

Title:

Clinical application of multimode respiratory training device combined with comprehensive pulmonary rehabilitation training during the perioperative period of thoracoscopic surgery for lung cancer

作者:

曹冬霞¹; 杨恩艳²; 付启梅³; 徐心怡³; 王荣花⁴; 张静文⁵

210001 南京,东部战区空军医院心胸泌尿外科¹；210001 南京,东部战区空军医院重症医学科²；210001 南京,东部战区空军医院护理部³；210001 南京,东部战区空军医院呼吸内科⁴；100039 北京,解放军总医院第二医学中心综合外科⁵

Author(s):

Cao Dongxia¹;  Yang Enyan²;  Fu Qimei³;  Xu Xinyi³;  Wang Ronghua⁴;  Zhang Jingwen⁵.

¹Department of Cardiothoracic Urology, Air Force Hospital of Eastern Theater Command, Nanjing 210001, China; ²Department of Critical Care Medicine, Air Force Hospital of Eastern Theater Command, Nanjing 210001, China; ³Department of Nursing, Air Force Hospital of Eastern Theater Command, Nanjing 210001, China; ⁴Department of Respiratory Medicine, Air Force Hospital of Eastern Theater Command, Nanjing 210001, China; ⁵Department of General Surgery, Second Medical Center, PLA General Hospital, Beijing 100039, China

关键词:

支气管肺癌;  肺康复训练;  多模式呼吸训练仪;  胸腔镜围手术期

Keywords:

Bronchogenic carcinoma;  Pulmonary rehabilitation training;  Multimode respiratory training device;  Perioperative period of thoracoscopic surgery

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2025.02.017

摘要:

目的 分析多模式呼吸训练仪结合全程肺康复训练(pulmonary rehabilitation training, PRT)管理在肺癌胸腔镜围术期的应用。方法 选择2023年2月至2023年10月我院收治的胸腔镜下肺叶切除术肺癌患者72例,随机分为对照组37例和观察组35例。对照组采用肺癌围术期管理,观察组在对照组基础上采用全程PRT管理和多模式呼吸训练仪。比较两组术前1 d、术后5 d和术后1个月肺功能指标、生活质量评分及术后并发症,判断临床疗效。结果 观察组术前1 d 1秒用力呼气量(first second vital capacity, FEV₁)(57.83±3.85)%、用力肺活量(forced vital capacity, FVC)(2.26±0.35)L、呼吸峰流量(peak expiratory flow, PEF)(4.20±0.27)L/m和末梢血氧饱度(saturation peripheral oxygen, SpO₂)(93.34±3.06)%高于对照组(P<0.05),术后28 d FEV₁(69.54±7.13)% 、FVC(2.83±0.48)L、 PEF(4.48±0.39)L/m 、SpO₂(95.49±3.08)% 高于对照组(P<0.01); 观察组术后5 d肺癌患者生命质量测定量表(QLICP-LU)(160.40±14.04)分和自我效能感量表(GSES)(34.34±2.88)分高于对照组(149.22±20.84)分、(31.91±4.81)分(P<0.05),术后28 d QLICP-LU(178.80±13.17)分和GSES(35.80±3.62)分高于对照组(158.05±16.71)分、(32.32±4.74)分(P<0.05); 术后肺部并发症发生率31.43%低于对照组78.38%(P<0.05); 观察组术后吸痰7例(20.00%)低于对照组16例(43.24%)(P<0.05)。术后1个月无死亡病例。结论 多模式呼吸训练仪结合全程PRT管理改善肺癌围术期肺功能指标,降低肺部并发症发生率,提高生活质量,是一种有效的围术期管理方法,具有临床意义。

Abstract:

Objective To analyze the application effect of a multimodal respiratory training device combined with comprehensive pulmonary rehabilitation training(PRT)management during the perioperative period of thoracoscopic surgery for lung cancer. Methods Seventy-two patients undergoing thoracoscopic lobectomy for lung cancer in our hospital from February 2023 to October 2023 were selected and randomly divided into a control group(37 cases)and an observation group(35 cases). The control group received conventional interventions perioperative care for lung cancer, while the observation group received comprehensive PRT management and a multimodal respiratory training device in addition to the conventional interventions. Lung function indicators(FEV₁, FVC, PEF, SpO₂), quality of life scores(QLICP-LU, GSES), and postoperative complications were compared between the two groups at preoperative day 1, postoperative day 5, and postoperative one month to evaluate the intervention efficacy. Results On preoperative day 1, the observation group showed higher FEV₁(57.83±3.85%), FVC(2.26±0.35)L, PEF(4.20±0.27)L/m, and SpO₂(93.34±3.06%)compared to the control group(P<0.05). By postoperative day 28, the observation group demonstrated significantly higher FEV₁(69.54±7.13)%, FVC(2.83±0.48)L, PEF(4.48±0.39)L/m, and SpO₂(95.49±3.08)% than the control group(P<0.01). On postoperative day 5, the observation group had higher QLICP-LU scores(160.40±14.04)and GSES scores(34.34±2.88)compared to the control group(149.22±20.84),(31.91±4.81)(P<0.05). By postoperative day 28, the observation group maintained higher QLICP-LU(178.80±13.17)and GSES scores(35.80±3.62)than the control group(158.05±16.71),(32.32±4.74)(P<0.05). The total incidence of postoperative pulmonary complications in the observation group(31.43%)was lower than that in the control group(78.38%)(P<0.05). Additionally, fewer patients in the observation group required postoperative sputum suction 7 cases(20.00%)compared to the control group 16 cases(43.24%)(P<0.05). There were no deaths one month after the operation. Conclusion The combination of a multimodal respiratory training device and comprehensive PRT management improves perioperative lung function, reduces the incidence of pulmonary complications, and enhances quality of life in lung cancer patients undergoing thoracoscopic surgery. This approach is an effective perioperative management strategy with significant clinical implications.

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通信作者: 杨恩艳, Email: 287148573@qq.com

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更新日期/Last Update: 2025-04-25