术前呼吸功能训练联合术后快速康复操对胸腔镜肺叶切除术肺癌患者呼吸功能、生活质量和康复效果的影响

摘要 目的：观察术前呼吸功能训练联合术后快速康复操对胸腔镜肺叶切除术肺癌患者呼吸功能、生活质量和康复效果的影响。方法：97例研究病例选取自2019年4月~2021年5月期间我院收治的行胸腔镜肺叶切除术肺癌患者。将97例患者根据信封抽签法分为对照组（48例）和观察组（49例），对照组患者予以术前呼吸功能训练和手术常规康复训练，观察组患者在对照组基础上联合术后快速康复操。对比两组术前、术后1周的呼吸功能、生活质量和康复效果，对比两组术后并发症发生率。结果：观察组术后1周用力肺活量（FVC）、第1秒用力呼气容积（FEV₁）、动脉血氧分压（PaO₂）高于对照组（P<0.05）。观察组术后1周动脉二氧化碳分压（PaCO₂）低于对照组（P<0.05）。观察组术后1周症状领域评分低于对照组（P<0.05）。观察组术后1周功能领域、总体健康状况评分高于对照组（P<0.05）。观察组患者的术后肛门排气时间、保留尿管时间、保留胸管时间、住院时间短于对照组（P<0.05）。观察组的术后并发症发生率低于对照组（P<0.05）。结论：术前呼吸功能训练联合术后快速康复操应用于胸腔镜肺叶切除术肺癌患者，可促进术后康复，改善其呼吸功能，提高生活质量，减少并发症发生风险。

Effects of Preoperative Respiratory Function Training Combined with Postoperative Rapid Rehabilitation Exercise on Respiratory Function, Quality of Life and Rehabilitation of Lung Cancer Patients Undergoing Thoracoscopic Lobectomy

ABSTRACT Objective: To observe the effect of preoperative respiratory function training combined with postoperative rapid rehabilitation exercise on respiratory function, quality of life and rehabilitation effect of lung cancer patients undergoing thoracoscopic lobectomy. Methods: 97 patients with lung cancer who underwent thoracoscopic lobectomy in our hospital from April 2019 to may 2021 were selected. 97 patients were divided into control group (48 cases) and observation group (49 cases) by envelope lottery. The patients in the control group were given preoperative respiratory function training and routine rehabilitation training. The patients in the observation group were combined with postoperative rapid rehabilitation exercise on the basis of the control group. The respiratory function, quality of life and rehabilitation effect of the two groups before and 1 week after operation were compared, and the incidence of postoperative complications was compared between the two groups. Results: The forced vital capacity (FVC), forced expiratory volume in the first second(FEV₁) and arterial oxygen partial pressure (PaO₂) in the observation group were higher than those in the control group (P<0.05). The arterial partial pressure of carbon dioxide (PaCO₂) in the observation group was lower than that in the control group 1 week after operation(P<0.05). The score of symptom field in the observation group was lower than that in the control group one week after operation (P<0.05). The scores of functional areas and overall health status in the observation group were higher than those in the control group one week after operation(P<0.05). The anal exhaust time, urinary tube retention time, chest tube retention time, and hospital stay in the observation group were shorter than those in the control group(P<0.05). The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05). Conclusion: The application of preoperative respiratory function training combined with postoperative rapid rehabilitation exercise in patients with lung cancer after thoracoscopic lobectomy can promote postoperative rehabilitation, improve their respiratory function, improve their quality of life and reduce the risk of complications.