三联预康复模式在胸腔镜肺癌手术患者中的应用价值

Application value of triple pre-rehabilitation mode in treating patients with thoracoscopic surgery for lung cancer

  • 摘要:
    目的 探讨三联预康复模式对胸腔镜肺癌手术患者预后的影响。
    方法 将148例拟行胸腔镜肺癌手术患者随机分为试验组和对照组,每组74例。对照组给予围术期常规护理干预,试验组联合应用三联预康复方案。在入院时、手术前以及术后1个月时,比较2组患者心理状态、血清营养学指标、肺功能及运动耐力,记录2组术后肺部并发症发生情况。
    结果 研究过程中,试验组资料缺失1例,对照组中途退出2例、资料缺失1例。手术前及术后1个月,试验组患者汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分低于对照组,试验组患者血清前白蛋白(PA)、视黄醇结合蛋白(RBP)、铁蛋白(FER)、转铁蛋白(TRF)高于对照组,试验组患者第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、每分钟最大通气量(MVV)、6分钟步行试验(6MWT)高于对照组,上述组间差异均有统计学意义(P < 0.05)。试验组并发症发生率为5.48%, 低于对照组的16.90%(P < 0.05)。
    结论 三联预康复模式应用于胸腔镜肺癌手术患者中安全、有效,可缓解焦虑、抑郁程度,改善术前及术后营养状况,增强肺功能与运动耐力,降低术后肺部并发症的发生风险。

     

    Abstract:
    Objective To explore the effect of triple pre-rehabilitation mode on the prognosis of patients with thoracoscopic surgery for lung cancer.
    Methods A total of 148 patients with thoracoscopic surgery for lung cancer were randomly divided into experimental group and control group, with 74 cases in each group. The control group was given routine nursing intervention in perioperative period, while the experimental group was given additional triple pre-rehabilitation plan. At the time points of hospital admission, before operation and one month after operation, the mental state, serum nutritional indexes, lung function and exercise endurance were compared between two groups, and the incidence of postoperative pulmonary complications in both groups was recorded.
    Results During the study, data of one case in the experimental group was lost, and two cases withdrew from the study and data of one case in the control group was lost. Before operation and one month after operation, the scores of the Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD) in the experimental group were lower than those in the control group, the levels of serum prealbumin (PA), retinol binding protein (RBP), ferritin (FER) and transferrin (TRF) in the experimental group were higher than those in the control group, the values of the forced expiratory volume in the first second (FEV1), the forced vital capacity (FVC), the maximum ventilatory volume per minute (MVV) and 6-minute walking test (6MWT) in the experimental group were higher than those in the control group, and the between-group differences mentioned above were statistically significant (P < 0.05). The incidence of complications in the experimental group was 5.48%, which was significantly lower than 16.90% in the control group (P < 0.05).
    Conclusion The triple pre-rehabilitation mode is safe and effective in the treatment of patients with thoracoscopic surgery for lung cancer, which can alleviate degrees of anxiety and depression, improve preoperative and postoperative nutritional status, enhance pulmonary function and exercise endurance, and reduce the risk of postoperative pulmonary complications.

     

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