摘要
目的本研究旨在探索老年食管癌患者肺功能锻炼依从性对术后并发症以及生活质量的影响。方法招募2019年2月—2019年9月在南京医科大学第一附属医院进行胸腔镜下胸段食管癌切除吻合术老年患者71例。评估患者术后肺功能锻炼依从性,将患者分为依从性优良组和依从性较差组,比较2组之间与术后肺部并发症、肺功能、运动耐力、呼吸困难等级、生活质量等指标的差异,分析依从性与这些指标的相关性。结果功能锻炼依从性优良组术后肺部并发总发生率、肺炎发生率低于依从性较差组(P<0.05)。肺功能锻炼依从性优良组肺功能第1 s用力呼气量(forced expiratory volume in 1s,FEV1)、呼气峰流速值(peak expiratory flow,PEF)、用力肺活量(forced vital capacity,FVC)均高于依从性较差组(P<0.05)。肺功能锻炼依从性优良组6 min步行试验(6-minute walk test,6 MWT)距离大于依从性较差组(P<0.05);肺功能锻炼依从性优良组MMRC评级量表4~5级患者比例低于依从性较差组(P<0.05)。肺功能锻炼依从性优良组SF-36评分量表中的生理功能、生理职能、社会功能、一般健康评分高于依从性较差组(P<0.05)。相关性分析表明,依从性评分与FEV1、PEF、FVC、6 MWT之间正相关(r>0,P<0.05);依从性评分与MMRC之间负相关(r<0,P<0.05)。结论提高老年食管癌患者围手术期肺功能锻炼依从性,可以降低患者术后肺部并发症、改善患者肺功能、运动耐受力,提高患者生活质量。
Objective To explore the effect of lung exercise compliance on postoperative complications and quality of life in elderly patients with esophageal cancer.Methods A total of 71 elderly patients who underwent thoracoscopic resection and anastomosis of thoracic esophageal cancer in First Affiliated Hospital of Nanjing Medical University from February 2019 to September 2019 were recruited.According to the compliance of postoperative lung function exercise,they were divided into good compliance group and poor compliance group.The differencesofpulmonary complications,pulmonary function,exercise endurance,dyspnea grade and quality of life between the two groups were compared,and the correlation between compliance and these indicators was analyzed.Results The incidences of postoperative pulmonary complications,pneumonia and chest infection in the good compliance group was lower than those in the poor compliance group(P<0.05).Forced expiratory volume in 1 s(FEV1),peak expiratory flow value(EFV),PEF and forced vital capacity(FVC)in the good compliance groupwere higher than those inthepoor compliance group(P<0.05).The distance of 6-minute walk test(6 MWT)in the good compliance group was longer than that in the poor compliance group(P<0.05).The proportion of patients with grade 4-5 on MMRC rating scale in the goodcompliance group was lower than that in the poor compliance group(P<0.05).The item scores of physiological function,role physical,social function and general health in the SF-36 score scale in the good compliance groupwere higher than those in the poor compliance group(P<0.05).Correlation analysis showed that compliance score was positively correlated with FEV1,PEF,FVC and 6 MWT(r>0,P<0.05),and negatively correlated with MMRC(r<0,P<0.05).Conclusion Improving the compliance of perioperative lung function exercise in elderly patients with esophageal cancer can reduce postoperative pulmonary complications,improve lung function and exercise tolerance,and improve the quality of life of patients.
作者
高立红
曹娟
杨丹丹
Gao Lihong;Cao Juan;Yang Dandan(Department of Thoracic Surgery,First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210000,P.R.China)
出处
《老年医学与保健》
CAS
2021年第6期1205-1208,1247,共5页
Geriatrics & Health Care
关键词
老年
食管癌
依从性
肺功能
elderly
esophageal cancer
compliance
lung function
