| 张莉,沈晓微,沈晓咏,吴美,夏露.围术期系统肺功能预康复训练在日间肺结节手术患者中的疗效[J].中国康复,2022,37(12):722-726 |
| 围术期系统肺功能预康复训练在日间肺结节手术患者中的疗效 |
| Efficacy of perioperative systemic pulmonary function pre-rehabilitation training in patients undergoing daytime pulmonary nodule surgery |
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| DOI： |
| 中文关键词: 肺结节 日间手术 胸腔镜 围术期 预康复训练 肺功能 |
| 英文关键词: Pulmonary nodules Day surgery Thoracoscopy Perioperative period Pre-rehabilitation training Pulmonary function |
| 基金项目:科技部国家重点研发计划项目（2019YFE0105600）;复旦大学复星护理科研基金（FNF202116）；2021年临床科技创新项目（SHDC20221218） |
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| 中文摘要: |
| 目的：探讨围术期系统肺功能预康复训练在日间肺结节手术患者中的应用效果。方法：选取94例行胸腔镜下肺节段切除术或肺楔形切除术患者作为研究对象，随机分为对照组和观察组各47例，对照组给予常规护理，观察组在常规护理基础上给予心理疏导、呼吸训练、清肺排痰训练、呼吸肌力量训练、抗阻呼吸激励式肺量计训练、有氧运动训练等系统肺功能预康复训练，观察2组患者干预前、术前、术后12h的肺功能，比较2组患者气管导管、胸腔引流管留置时间，评估并比较2组患者生活质量和术后随访情况。结果：术前，2组患者第1秒用力呼气容积（ FEV1）、用力肺活量（FVC）及每分钟最大通气量（MVV）均高于同组干预前（P<0.05），且观察组显著高于同期对照组（P<0.05）；术后12h，2组患者上述各指标均较术前降低（P<0.05），且对照组均低于干预前（P<0.05），观察组均高于干预前（P<0.05）。观察组患者气管导管、胸腔引流管留置时间均短于对照组（P<0.05）。随访1个月，观察组患者圣·乔治医院呼吸问题生活质量调查问卷(SGRQ)评分低于同期对照组（P＜0.05）。观察组患者随访1个月出院后非计划再就诊和再入院率低于对照组（P<0.05）。结论：围术期系统预康复训练可有效提高日间肺结节手术患者术前肺功能，降低手术对肺功能的不良影响，对维持患者术后短期生活质量和预防术后并发症均具有积极的作用。 |
| 英文摘要: |
| Objective: To investigate the effectiveness of perioperative systemic pulmonary function pre-rehabilitation training in patients undergoing daytime pulmonary nodule surgery. Methods: A total of 94 patients who underwent thoracoscopic pulmonary nodule resection or pulmonary wedge resection were selected as the research subjects and randomly divided into the control group and the observation group. The control group was given routine nursing, and the observation group was given psychological counseling, breathing training, lung clearing and expectoration training, respiratory muscle strength training, resistance breathing stimulation spirometer training, aerobic exercise training and other systematic pulmonary function pre-rehabilitation training on the basis of perioperative routine nursing. The pulmonary function of the two groups before the intervention, before the operation, and 12 h after the operation was observed. The indwelling time of the tracheal tube and the thoracic drainage tube was compared between the two groups, and the quality of life and postoperative follow-up outcome of the two groups were evaluat-ed and compared. Results: Before operation, FEV1, FVC and MVV in the two groups were higher than those in the same groups before intervention, and those in the observation group were significantly higher than those in the control group at the same time (P<0.05). At 12 h after operation, the above indexes in the two groups were significantly lower than those before operation (P<0.05), and those in the control group were lower than those before the intervention, while those in the observation group were higher than those before the intervention (P<0.05). In addition, the indwelling time of tracheal tube and thoracic drainage tube in the observation group was shorter than that in the control group (P<0.05). During one month follow-up period, the SGRQ score in the observation group was lower than that in the control group (P<0.05). The unplanned readmission and readmission rates of patients in the observation group were lower than those in the control group after one month of follow-up (P<0.05). Conclusion: Preoperative systemic pre-rehabilitation training can effectively improve the preoperative pulmonary function of patients undergoing daytime pul-monary nodule surgery, reduce the adverse effects of surgery on pulmonary function, and have a positive effect on maintaining short-term postoperative quality of life and preventing postoperative complications. |
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