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目的探讨强化肺康复锻炼在重度肺通气功能障碍肺癌患者围手术期中的应用价值。方法选取2011年12月至2015年12月间江苏省无锡市第四人民医院收治的126例重度肺通气功能障碍肺癌患者,采用随机数字表法分为观察组和对照组,每组63例。观察组患者在常规护理的基础上联用强化肺康复锻炼,对照组患者采用围手术期常规护理,于治疗前后行肺功能检测,比较两组患者临床疗效及并发症情况。结果两组患者治疗后肺功能指标(第1秒用力呼气量、用力肺活量、最大通气量、一氧化碳弥散总量、千克摄氧量、氧脉搏、动脉血二氧化碳分压、呼气峰流速)较治疗前增加,且观察组高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后肺功能指标(残气量、功能残气量、潮气量、呼吸频率)较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组患者机械通气时间、术后氧疗时间、引流管留置时间、术后住院时间少于对照组,差异有统计学意义(P<0.05)。观察组患者并发症发生率(肺部感染、肺不张、呼吸衰竭)低于对照组,差异有统计学意义(P<0.05)。结论强化肺康复锻炼可显著改善重度肺通气功能障碍肺癌患者的肺功能,疗效显著且安全性高,值得临床推广应用。
Objective To investigate the value of intensive lung rehabilitation training in the perioperative period of lung cancer patients with severe pulmonary ventilation dysfunction. Methods A total of 126 patients with severe pulmonary ventilation dysfunction admitted to the Fourth People’s Hospital of Wuxi City, Jiangsu Province from December 2011 to December 2015 were randomly divided into observation group and control group with 63 cases in each group. The patients in the observation group were treated with intensive pulmonary rehabilitation exercises on the basis of routine nursing. The patients in the control group were treated with perioperative routine nursing. The pulmonary function tests were performed before and after treatment. The clinical efficacy and complications were compared between the two groups. Results After treatment, pulmonary function parameters (forced expiratory volume in 1 second, forced vital capacity, maximal ventilation, total carbon monoxide dispersion, kg oxygen uptake, oxygen pulse, arterial partial pressure of carbon dioxide and peak expiratory flow) Before treatment increased, and the observation group was higher than the control group, the difference was statistically significant (P <0.05). The pulmonary function indexes (residual capacity, functional residual capacity, tidal volume, respiration rate) of two groups after treatment were lower than those before treatment, and the observation group was lower than the control group, the difference was statistically significant (P <0.05). The observation group patients with mechanical ventilation time, postoperative oxygen therapy time, drainage tube indwelling time, postoperative hospital stay less than the control group, the difference was statistically significant (P <0.05). The incidence of complications (pulmonary infection, atelectasis, respiratory failure) in the observation group was lower than that in the control group, with significant difference (P <0.05). Conclusion Intensive lung rehabilitation exercises can significantly improve lung function in lung cancer patients with severe pulmonary ventilation dysfunction, with significant efficacy and safety, which is worthy of clinical application.