肺康复在高龄原发性非小细胞肺癌合并慢性阻塞性肺疾病患者围术期中的应用效果  

Application Effect of Pulmonary Rehabilitation in the Perioperative Period of Elderly Primary Non-Small Cell Lung Carcinomas Patients Complicated with Chronic Obstructive Pulmonary Disease

作　　者：方寅[1] 谢伟[1] 方明[1] 许涛[1] FANG Yin;XIE Wei;FANG Ming;XU Tao(Department of Thoracic Surgery,the First People's Hospital of Wuhu,Wuhu 241000,China)

机构地区：[1]安徽省芜湖市第一人民医院胸外科,241000

出　　处：《实用心脑肺血管病杂志》2025年第6期103-107,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：安徽省芜湖市科技局重点研发与成果转化项目(2023yf097);安徽省重点研究与开发计划立项项目(2022i07020069)。

摘　　要：目的探讨肺康复在高龄原发性非小细胞肺癌(NSCLC)合并慢性阻塞性肺疾病(COPD)患者围术期中的应用效果。方法选取2022年6月—2024年6月芜湖市第一人民医院收治的高龄原发性NSCLC合并COPD患者82例作为研究对象,根据随机数字表法将患者分为常规组和肺康复组,各41例。常规组患者围术期采取常规康复,肺康复组患者围术期采用肺康复,两组均持续干预3周。比较两组住院时间、术中出血量、手术时间,术前及术后1、2、3周肺功能指标〔呼气流量峰值(PEF)、第1秒用力呼气容积(FEV_(1))、FEV_(1)/用力肺活量(FVC)〕、6分钟步行距离(6MWD),术后1、3周生命质量测定系列量表的核心问卷(QLQ-C30)评分,并观察两组术后并发症发生情况。结果肺康复组住院时间短于常规组(P<0.05)。两组术中出血量、手术时间比较,差异无统计学意义(P>0.05)。干预方法与时间在FEV_(1)/FVC上存在交互作用(P<0.05),干预方法与时间在PEF、FEV_(1)上不存在交互作用(P>0.05);干预方法、时间在PEF、FEV_(1)、FEV_(1)/FVC上主效应显著(P<0.05)。肺康复组术后1、2、3周PEF、FEV_(1)、FEV_(1)/FVC高于常规组(P<0.05)。干预方法与时间在6MWD上存在交互作用(P<0.05);干预方法、时间在6MWD上主效应显著(P<0.05)。肺康复组术后1、2、3周6MWD长于常规组(P<0.05)。干预方法与时间在QLQ-C30评分上不存在交互作用(P>0.05);干预方法、时间在QLQ-C30评分上主效应显著(P<0.05)。肺康复组术后1、3周QLQ-C30评分高于常规组(P<0.05)。肺康复组术后并发症总发生率低于常规组(P<0.05)。结论肺康复可有效改善高龄原发性NSCLC合并COPD患者的肺功能,提高运动耐量,缩短住院时间,提高生活质量,且可降低术后并发症发生率。Objective To explore the application effect of pulmonary rehabilitation in the perioperative period of elderly primary non-small cell lung carcinomas(NSCLC)patients complicated with chronic obstructive pulmonary disease(COPD).Methods Eighty-two cases of elderly primary NSCLC patients complicated with COPD admitted to the First People's Hospital of Wuhu from June 2022 to June 2024 were selected as the study subjects,and the patients were divided into the conventional group and the pulmonary rehabilitation group according to the random number table method,with 41 cases in each group.In the perioperative period,patients in the conventional group accepted conventional rehabilitation,and patients in the pulmonary rehabilitation group adopted pulmonary rehabilitation.Both groups were invented for 3 weeks.Hospitalization time,intraoperative bleeding volume,operation time,pulmonary function indexes[peak expiratory flow(PEF),forced expiratory volume in one second(FEV_(1)),FEV_(1)/forced vital capacity(FEV_(1)/FVC)],6-minute walking distance(6MWD)before operation and at 1,2,3 weeks after operation,Quality of Life Questionnaire-Core 30(QLQ-C30)score before operation and at 1,3 weeks after operation were compared between the two groups.Incidence of postoperative complications were observed of the two groups.Results The hospitalization time in the pulmonary rehabilitation group was shorter than that in the conventional group(P<0.05).There was no statistically significant difference of intraoperative bleeding volume,operation time between the two groups(P>0.05).There was an interaction between intervention methods and time on FEV_(1)/FVC(P<0.05),but there was no interaction between intervention methods and time on PEF and FEV_(1)(P>0.05).The main effects of intervention methods and time on PEF,FEV_(1),and FEV_(1)/FVC were significant(P<0.05).At 1,2,3 weeks after operation,PEF,FEV_(1),FEV_(1)/FVC in the pulmonary rehabilitation group were higher than those in the conventional group(P<0.05).There was an interaction between inter

关 键 词：癌 非小细胞肺 肺疾病 慢性阻塞性 高龄 围术期 肺康复 

分 类 号：R730.26[医药卫生—肿瘤] R563.9[医药卫生—临床医学]