振动呼气正压装置与诱发性肺量计在肺癌术后患者康复训练中的应用研究

doi:10.3761/j.issn.0254-1769.2021.03.002

摘要/Abstract

摘要：

目的比较振动呼气正压装置（oscillatory positive expiratory pressure device, OPEPD）联合诱发性肺量计训练与主动循环呼吸技术（active cycle of breathing techniques, ACBT）训练对肺癌术后患者肺康复效果的影响。方法选取2018年1月—2019年8月在郑州市某三级甲等医院胸外科行单孔胸腔镜下肺癌根治术的87例患者为研究对象, 采用随机数字表法将其分为试验组与对照组。试验组（44例）采用OPEPD联合诱发性肺量计进行肺康复训练, 对照组（43例）采用ACBT进行肺康复训练, 干预5 d, 比较两组术后并发症发生情况、6 min步行距离、肺活量、Borg呼吸困难评分、肺癌患者生活质量评分、衰弱评分及康复护理满意度。结果两组的年龄、性别、急性生理与慢性健康状况评分、肺癌分期及合并症等一般资料比较, 差异无统计学意义（P>0.05）;试验组6 min步行距离远于对照组、肺活量高于对照组, 差异有统计学意义（P<0.05）;试验组术后呼吸功能不全发生率、Borg呼吸困难评分、肺癌患者生活质量评分及衰弱评分低于对照组, 差异有统计学意义（P<0.05）;试验组康复护理满意度高于对照组, 差异有统计学意义（P=0.034）。结论 OPEPD联合诱发性肺量计训练能够减轻肺癌术后患者的衰弱程度, 减少并发症, 提高其肺活量、运动耐量和康复护理满意度。

关键词: 振动呼气正压装置, 主动循环呼吸技术, 诱发性肺量计, 肺康复, 肺癌, 护理

Abstract:

Objective To evaluate the value of oscillatory positive expiratory pressure device（OPEPD）combined with incentive spirometer（IS）and active cycle of breathing techniques（ACBT） in pulmonary rehabilitation for patients with lung cancer after surgery. Methods 87 patients with lung cancer undergoing single-hole thoracoscopic radical resection of lung cancer from January 2018 to August 2019 in a Level A tertiary hospital were randomly divided into an intervention group and a control group. 43 patients in the control group received ACBT training, while 44 patients in the intervention group received OPEPD combined with IS approach for lung rehabilitation. Both groups were trained for 5 days, and the incidences of complications, 6-minute walk distance（6MWD）, vital capacity（VC）, Borg dyspnea scores, quality of life（QLQ-LC29） for lung cancer patients, weakness（Frail）scale and satisfaction of rehabilitation nursing were compared between 2 groups. Results There was no significant difference between 2 groups in age, gender, acute physiology and chronic health evaluation（APACHE Ⅱ）, lung cancer stage and baseline of complications（P>0.05）;6MWD and VC in the intervention group were higher than those in the control group（P<0.05）;the complication of respiratory insufficiency, Borg dyspnea scores, QLQ-LC29 and Frail scale in the intervention group were lower than those in the control group（P<0.05）;the satisfaction degree of rehabilitation were higher than that in the control group（P=0.034）. Conclusion OPEPD combined with IS cannot only reduce weakness and complications, but also improve lung capacity, tolerance for exercises, and nursing satisfaction for patients with lung cancer after surgery.

Key words: Oscillatory Positive Expiratory Pressure Device, Active Cycle of Breathing Techniques, Incentive Spirometer, Pulmonary Rehabilitation, Lung Cancer, Nursing Care

张新娜, 李倩倩, 王红钰, 徐瑞艳, 李春红. 振动呼气正压装置与诱发性肺量计在肺癌术后患者康复训练中的应用研究[J]. 中华护理杂志, 2021, 56(3): 330-335.

ZHANG Xinna, LI Qianqian, WANG Hongyu, XU Ruiyan, LI Chunhong. The research of the rehabilitation effects of oscillatory positive expiratory pressure device combined with incentive spirometer for patients with lung cancer after surgery[J]. Chinese Journal of Nursing, 2021, 56(3): 330-335.

图/表 3

Table 1 Comparison of general information between two groups

Table 2 Comparison of 6-minute walk distance, vital capacity,quality of life scores for lung cancer patients,weakness scores and Borg dyspnea scores before and after intervention betweentwo groups（$\bar{x}$±s）

Table 3 Comparison of complications within one week between two groups[cases（precent,%）]

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