术前预康复模式在低肺功能肺癌患者围术期的应用  

Preoperative prehabilitation in perioperative period of lung cancer patients with poor lung function

作　　者：杨晓歆 丁洁芳 刘锋 张羽 殷瑛 YANG Xiao-xin;DING Jie-fang;LIU Feng;ZHANG Yu;YIN Ying(Department of Thoracic Surgery,The Affiliated Brain Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China;不详)

机构地区：[1]南京医科大学附属脑科医院胸外科,江苏南京210029 [2]南京医科大学附属脑科医院康复科,江苏南京210029

出　　处：《中国临床研究》2022年第4期576-580,共5页Chinese Journal of Clinical Research

基　　金：南京市卫生科技发展专项资金项目(YKK20092)。

摘　　要：目的探讨低肺功能肺癌手术患者基于加速康复外科(ERAS)的预康复模式及临床应用效果。方法选择2020年6月至2021年5月南京脑科医院胸外科连续收治的行单孔胸腔镜手术的91例低肺功能肺癌患者为研究对象,随机分为对照组(44例)和研究组(47例)。采用常规模式对对照组患者进行术前干预,采用预康复模式对研究组患者进行干预,分析患者围术期自我管理能力、术后肺部并发症发生率、胸管留置时间、术后住院时间和住院总时间。结果研究组手术前的戒烟完成率高于对照组(P<0.05);术前的焦虑测评达标率、术后早期下床活动和自主咳嗽依从性达标率均明显高于对照组(P<0.01)。研究组术后痰潴留、胸腔积液、肺部感染等总并发症发生率低于对照组(P<0.01);术后胸管留置时间、术后住院时间、住院总时间均少于对照组(P<0.01)。结论低肺功能肺癌患者术前应用预康复模式可提高患者围术期的自我管理能力,减少术后肺部并发症的发生,缩短住院时间。Objective To explore the preoperative prehabilitation model based on enhanced recovery after surgery(ERAS)in lung cancer patients with poor lung function treated with operation and its clinical application effect.Methods A total of 91 lung cancer patients with low lung function,who underwent single-hole thoracoscopic lobectomy in Nanjing Brain Hospital from June 2020 to May 2021 were recruited and randomly divided into control group(n=44)and study group(n=47).The routine preoperative intervention mode was performed in control group,and the prehabilitation mode was conducted in study group before operation.The perioperative self-management ability,the incidence of postoperative pulmonary complications,chest tube retention time,postoperative hospital stay and total length of hospital stay were analyzed and compared between two groups.Results The preoperative completion rate for smoking cessation in study group was significantly higher than that in control group(P<0.05).The compliance rates of preoperative anxiety assessment,postoperative early ambulation and voluntary cough in study group were significantly higher than those in control group(P<0.01).The incidences of postoperative sputum retention,pleural effusion and lung infection in study group were significantly lower than those in control group(P<0.01).The chest tube retention time,postoperative hospital stay and total length of hospital stay in study group were significantly shortened compared with those in control group(P<0.01).Conclusion For the lung cancer patients with poor pulmonary function undergoing surgery,the preoperative prehabilitation model can improve perioperative self-management abilities,reduce the incidences of postoperative pulmonary complications and shorten the hospital stay.

关 键 词：预康复 肺功能 肺癌 加速康复外科 

分 类 号：R473.6[医药卫生—护理学] R493[医药卫生—临床医学]