摘要
目的探讨加速康复外科(enhanced recovery after surgery,ERAS)模式下肺癌术后住院期间康复治疗对患者肺功能及运动能力的影响。方法选取2017年9月—2018年12月入住上海交通大学医学院附属瑞金医院胸外科的110例胸腔镜下肺叶切除的肺癌患者,随机分为术后康复治疗组(试验组)54例与术后非康复治疗组(对照组)56例。试验组术后24 h内早期下床活动,并进行呼吸康复训练;对照组术后未进行康复治疗。两组分别于术前和出院前进行肺功能与6分钟步行距离(6-minute walking distance,6MWD)测试,比较两组患者肺功能与运动能力的差异。结果试验组与对照组患者术前用力肺活量(forced vital capacity,FVC)分别为(2.45±0.57)、(2.47±0.61)L,第1秒用力呼气容积(forced expiratory volume in the first second,FEV1)分别为(2.29±0.55)、(2.22±0.55)L,6MWD分别为(592±51)、(576±57)m,组间差异均无统计学意义(P>0.05);出院前试验组与对照组患者的FVC分别为(1.43±0.36)、(1.19±0.33)L,FEV1分别为(1.28±0.32)、(1.06±0.61)L,6MWD分别为(264±43)、(218±37)m,与术前比较均降低,差异有统计学意义(P<0.01);试验组出院前FVC、FEV1及6MWD均优于对照组,差异有统计学意义(P<0.01)。结论 ERAS模式下肺癌术后住院期间康复治疗可更有效地改善患者肺功能和促进运动能力的恢复。
Objective To explore the effects of rehabilitation therapy on postoperative pulmonary function and exercise capacity of patients with lung cancer during the hospitalization in the setting of enhanced recovery after surgery(ERAS)protocols.Methods A total of 110 lung cancer patients undergoing thoracoscopic lobectomy in the Department of Thoracic Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from September 2017 to December 2018 were randomly divided into the rehabilitation treatment group(the trial group,n=54)and the nonrehabilitation treatment group(the control group,n=56).The trial group got out of bed within 24 hours after surgery and performed respiratory rehabilitation training.The control group did not receive rehabilitation after surgery.Pulmonary function and 6-minute walking distance(6 MWD)were evaluated preoperatively and prior to discharge in both groups to compare the differences in pulmonary function and exercise capacity between the two groups.Results The preoperative forced vital capacity(FVC)in the trial group and the control group were(2.45±0.57)and(2.47±0.61)L,respectively;the forced expiratory volume in the first second(FEV1)were(2.29±0.55)and(2.22±0.55)L,respectively;6 MWD were(592±51)and(576±57)m,respectively;the differences between the two groups were not statistically significant(P>0.05).Prior to discharge,the FVC in the trial group and the control group were(1.43±0.36)and(1.19±0.33)L,respectively;FEV1 were(1.28±0.32)and(1.06±0.61)L,respectively;6 MWD were(264±43)and(218±37)m,respectively.The results of predischarge evaluation were significantly lower than those of preoperative evaluation(P<0.01).The pre-discharge FVC,FEV1,and 6 MWD in the trial group were significantly superior to those in the control group(P<0.01).Conclusion In the setting of ERAS protocols,postoperative rehabilitation therapy during hospitalizations can improve pulmonary function and promote the recovery of exercise capacity in lung cancer patients more effectively.
作者
孙昕
韩丁培
黄卓琼
王朴
李鹤成
SUN Xin;HAN Dingpei;HUANG Zhuoqiong;WANG Pu;LI Hecheng(Department of Rehabilitation Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,P.R.China;Department of Thoracic Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,P.R.China;Department of Respiratory Medicine,Luwan Branch of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,P.R.China)
出处
《华西医学》
CAS
2019年第8期912-916,共5页
West China Medical Journal
基金
上海市卫生计生系统优秀学科带头人培养计划(2017BR055)
关键词
加速康复外科
康复治疗
肺肿瘤
肺叶切除术
Enhanced recovery after surgery
Rehabilitation therapy
Lung neoplasms
Pulmonary lobectomy
