Abstract:

Objective To construct a postoperative matching exercise training program for lung transplant patients and to evaluate the clinical application effect. Methods A non-concurrent controlled study was used. By convenience sampling method，patients undergoing lung transplantation in a tertiary A hospital in Hangzhou from December 2021 to March 2022 were included in a trial group with 35 cases，while the patients from April to November 2021 were recruited in a control group with 34 cases. Baseline data was consistent between the 2 groups. On the basis of the intervention program in the control group，the trial group received the matching exercise training program which was constructed based on the evidence and Delphi expert consultation method. It was divided into 4 stages according to the BODE index，including primary exercise，advanced exercise，intensive exercise and stable exercise，covering exercise mode，time，and intensity，etc. The control group received a routine pulmonary rehabilitation training program. The 6MWT distance standard time，deep inhalation volume standard time，hospitalization time，FEV1%，BMI，MBI and the incidence of adverse events during exercise training of 2 groups were compared. Results The standard time of the 6MWT distance and the deep inhalation volume in the trial group were lower than it in the control group（P<0.05）. The FEV1% and MBI at discharge in the trial group were lower than those in the control group（P<0.05）. There was no significant difference in length of stay，BMI and incidence of adverse events between the 2 groups（P>0.05）. Conclusion The matching exercise training program is accurate，safe and feasible，and it can promote the rapid postoperative rehabilitation of lung transplant patients.

Key words: Lung Transplantation, Exercise Training, Pulmonary Rehabilitation, Rehabilitation Nursing

摘要：

目的 构建肺移植术后患者匹配式运动训练方案并评价其应用效果。方法 采用非同期前后对照研究。便利选取杭州市某三级甲等医院2021年12月—2022年3月行肺移植术的患者35例作为试验组，2021年4月—11月行肺移植术的患者34例作为对照组，两组基线资料一致。试验组在对照组干预方案基础上，实施匹配式运动训练方案，该方案基于循证、德尔菲专家咨询法构建，根据BODE指数，分为初级运动期、进阶运动期、强化运动期、稳定运动期4个阶段，涵盖运动方式、时间、强度等。对照组实施常规肺康复训练方案。比较两组6 min步行试验距离达标时间、术后实现深吸气量达标时间、术后住院时间以及出院时第1秒用力呼气容积占预计值百分比、体重指数、改良Barthel指数和运动训练过程中不良事件发生率。结果 试验组6 min步行试验距离达标时间、术后实现深吸气量达标时间均短于对照组（P<0.05）；试验组出院时第1秒用力呼气容积占预计值百分比、改良Barthel指数优于对照组（P<0.05）；两组术后住院时间、出院时体重指数以及运动训练过程中不良事件发生率比较，差异无统计学意义（P>0.05）。结论 匹配式运动训练方案具备精准性、安全性和可行性，能促进肺移植患者术后快速康复。

关键词: 肺移植, 运动训练, 肺康复, 康复护理