摘要
目的探讨与常规胸部理疗相比,非小细胞肺癌肺叶切除术后即刻肺部高频振动疗法的可行性。方法选择2017年1月~2018年1月哈尔滨医科大学附属第二医院胸外科66例非小细胞肺癌术后患者进行前瞻性单盲随机对照试验。患者随机分配到高频胸壁振荡组或常规物理治疗(对照)组。对照组患者每天4次常规胸部理疗;高频胸壁振荡组每天接受4次高频胸壁振荡治疗。主要评估术后第1秒用力呼气量的变化,其次是动脉氧分压和饱和度的变化。HFCWO组行HFCWO治疗能够被患者较好耐受,未发生与HFCWO相关的不良事件。结果 HFCWO组术后第3天和第5天的FEV1较术前值改变显著低于对照组(41.67±13.70[44] vs 52.85±10.97[57],P<0.05;38.79±13.95[39] vs 49.72±11.76[52],P<0.05),术后4 h和20 h血氧分压(mmHg)变化显著高于对照组(17.02±18.08[12.2] vs 2.51±12.21[1.8],P<0.05;18.75±24.67[15.9] vs 3.50±19.28[3.7],P<0.05),术后4 h血氧饱和度(%)变化显著高于对照组(2.15±2.76[1.5] vs 0.68±2.16[0.5],P<0.05),而两组术后第1天FEV1变化、FVC变化、入病房的氧分压氧饱和度变化、术后20 h氧饱和度变化无统计学意义(P>0.05)。结论高频胸壁振荡治疗可能是非小细胞肺癌患者术后护理的重要手段。
Objective To compare the feasibility of high-frequency vibration therapy of lungs after lobectomy for non-small cell lung cancer compared with conventional chest physiotherapy. Methods A prospective, single-blind randomized controlled trial was performed in 66 patients with non-small cell lung cancer who underwent thoracic surgery from the Second Affiliated Hospital of Harbin Medical University from January 2017 to January 2018. Patients were randomized to either the high-frequency chest wall oscillation group or the conventional physical therapy(control) group. The patients in the control group received routine chest physiotherapy four times a day;the high-frequency chest wall oscillating group received four high-frequency chest wall oscillations every day. The results were mainly to assess the change in forced expiratory volume at 1 second postoperatively, followed by changes in arterial oxygen partial pressure and saturation. HFCWO treatment in the HFCWO group was well tolerated by patients, and no adverse events associated with HFCWO occurred. Results The changes of FEV1 on the 3 rd and 5 th day after surgery in the HFCWO group were significantly lower than those in the control group(41.67±13.70[44] vs 52.85±10.97[57], P<0.05;38.79±13.95[39] vs 49.72±11.76[52], P<0.05), the change of oxygen partial pressure(mmHg) at 4 h and 20 h after operation was significantly higher than that of the control group [17.02±18.08[12.2] vs 2.51±12.21[1.8], P<0.05;18.75±24.67[15.9] vs 3.50±19.28[3.7], P<0.05], the oxygen saturation(%) change was significantly higher 4 h after surgery than the control group [2.15±2.76[1.5] vs 0.68±2.16[0.5], P<0.05], and there was no statistically significant change in FEV1, FVC change, oxygen partial pressure oxygen saturation in the ward, and oxygen saturation at 20 h after surgery, P>0.05). Conclusion High frequency chest wall oscillation therapy may be an important means of postoperative care for patients with non-small cell lung cancer.
作者
石瑞龙
SHI Rui-long(First Center Operating Room,The Second Affiliated Hospital of Harbin Medical University, Harbin 150081,China)
出处
《哈尔滨医科大学学报》
CAS
2019年第2期192-194,199,共4页
Journal of Harbin Medical University
关键词
胸部理疗
高频胸壁振荡
肺叶切除术
非小细胞肺癌
肺功能
chest therapy
high frequency chest wall oscillation
lobectomy
non-small cell lung cancer
pulmonary function
