序贯性膈肌锻炼对肺癌术后患者康复效果和并发症的影响  

Eff ect of sequential diaphragm exercise on the rehabilitation eff ect and complications of postoperative lung cancer patients

作　　者：王其燕[1] 王媚媚 邓炳丽 陈治历 黄靖雄 WANG Qiyan;WANG Meimei;DENG Bingli;CHEN Zhili;HUANG Jingxiong(The Second People's Hospital of Qinzhou,Qinzhou 535000,China;Qinzhou First People's Hospital,Qinzhou 535000,China)

机构地区：[1]钦州市第二人民医院,广西壮族自治区钦州市535000 [2]钦州市第一人民医院,广西壮族自治区钦州市535000

出　　处：《护理实践与研究》2025年第2期296-301,共6页Nursing Practice and Research

基　　金：钦州市科学研究与技术开发计划项目(编号:20176402)。

摘　　要：目的探讨序贯性膈肌锻炼对肺癌术后患者康复效果的影响。方法选取2020年10月—2022年12月入住钦州市某三甲医院心胸外科的肺癌患者94例,按照组间基线资料可比的原则分为观察组与对照组,各47例,观察组患者在围术期内接受序贯膈肌锻炼,对照组接受常规护理和呼吸治疗。医护人员在患者手术前、术后第2天、出院时采用肺功能指标、膈肌运动幅度、呼吸困难评分量表、6 min步行距离、术后并发症发生率等评估两组患者干预效果。结果两组患者在术前、术后第2天、出院时3个时间点的FVC、FEV_(1)、MVV的测量值出现先降低后升高的趋势(P时间<0.05);术后第2天、出院时观察组FVC、FEV_(1)、MVV的测量值优于对照组(P_(组间)<0.05);随着观察时间延长,两组患者FVC、FEV_(1)、MVV的测量值差异逐渐增大(P_(交互)<0.05)。两组患者在术前、术后第2天、出院时3个时间点的膈肌移动幅度和6 min步行距离出现先降低后增加的趋势,Borg评分则出现先升高后降低的趋势(P_(时间)<0.05);随着观察时间延长,观察组患者改善效果优于对照组(P_(组间)<0.05);两组患者膈肌活动幅度在术后第2天差别最大(P_(交互)<0.05),Borg评分随时间延长组间差别逐渐增大(P_(交互)<0.05),6 min步行距离在术后第2天对照组高于观察组、出院时观察组高于对照组(P_(交互)<0.05)。两组患者术后康复期间发生肺炎、肺不张、心律失常等并发症发生率比较差异无统计学意义(P>0.05)。结论对肺癌手术患者开展序贯性膈肌锻炼,有助于提升术后呼吸康复效果且减少并发症。Objective To explore the effect of sequential diaphragm exercise on the rehabilitation effect of postoperative lung cancer patients.Methods Ninety-four patients with lung cancer who were admitted to the Department of Cardiothoracic Surgery of a Class Ⅲ Grade A hospital in Qinzhou from October 2020 to December 2022 were selected and divided into an observation group and a control group of 47 cases each according to the principle of comparable baseline data between the groups.Patients in the observation group received sequential diaphragm exercise during the perioperative period,and patients in the control group received conventional care and respiratory therapy.Medical personnel used respiratory function indexes,diaphragm movement amplitude,dyspnoea rating scale,6-min walking distance,and the incidence of postoperative complications to assess the effect of the intervention in the two groups before the operation,on the second postoperative day,and at the time of discharge from the hospital.Results The measurement of FVC,FEV_(1),and MVV in the two groups at the three time points of preoperative,postoperative day 2,and discharge demonstrated a tendency of decreasing and then increasing(P_(time)<0.05).The measurement of FVC,FEV_(1),and MVV in the observation group was superior to,The data demonstrated that the observation group exhibited superior outcomes in comparison to the control group on postoperative day 2 and at discharge(P_(intergroup)<0.05).Furthermore,as the observation period extended,the difference was gradualcy increase between the two groups(P_(interaction)<0.05).The diaphragm movement amplitude and 6 min walking distance of the two groups at the three time points(preoperative,postoperative day 2,and discharge)exhibited a trend of decreasing and then increasing,while the Borg score demonstrated a trend of increasing and then decreasing(P_(time)<0.05).The prolongation of the observation period revealed that patients in the observation group exhibited superior improvement compared to those in the control

关 键 词：序贯性膈肌锻炼 呼吸功能 肺康复 肺癌 并发症 

分 类 号：R47[医药卫生—护理学]