Abstract：Objective To evaluate the effects of problem-oriented respiratory rehabilitation nursing on lung function, activity ability, length of hospital stay, and retention time of closed chest drainage tube in patients undergoing thoracoscopic radical resection for lung cancer, so as to provide a basis for improving the prognosis of patients with lung cancer surgery. Methods A total of 119 patients with lung cancer who underwent thoracoscopic radical resection for lung cancer in the First Affiliated Hospital of Anhui Medical University from October 2023 to June 2024 were selected and randomly divided into the intervention group (n=59) and the control group (n=60). The control group received routine respiratory rehabilitation nursing of thoracic surgery. On the basis of the treatment and guidance received by the control group, the intervention group implemented problem-oriented respiratory rehabilitation nursing. First second expiratory volume (FEV1) and forced vital capacity (FVC) were used to evaluate pulmonary function at 1 day before surgery and 3 days after surgery, and the 6-minute walk distance (6MWD) was used to evaluate physical activity. The incidence of pulmonary complications, length of hospital stay and retention time of closed chest drainage tube were collected through the hospital's electronic medical records system. The intervention effects between the two groups were compared using variance analysis of repeated-measures analysis of variance and log-rank test. Results The mean age of the control group was (60.77±9.31) years, with 28 males and 32 females. There were 4 cases of squamous cell carcinoma, 55 cases of adenocarcinoma, and 1 case of small cell carcinoma. The tumors were located in the right lobe in 41 cases. The mean age of the intervention group was (58.71±10.01) years, with 23 males and 36 females. There were 2 cases of squamous cell carcinoma, 56 cases of adenocarcinoma, and 1 case of small cell carcinoma. The tumors were located in the right lobe in 37 cases. There were no statistically significant differences in age, gender, education level, pathological type, and tumor location between the two groups (all P>0.05). Three days after surgery, there was an interaction effect between the group and the time in FEV1, FVC, and 6MWD between the two groups. The FEV1 and 6MWD in the intervention group were higher than those in the control group (both P<0.05). There was no statistically significant difference in FVC between the groups (P>0.05). There were 3 cases of postoperative complications in the control group, and no cases in the intervention group. Log-rank test showed that the length of hospital stay and retention time of closed chest drainage tube after surgery in the intervention group were shorter than those in the control group (both P<0.05). Conclusion The problem-oriented respiratory rehabilitation nursing can improve the lung function and activity ability of patients with lung cancer after surgery, shorten the length of hospital stay and retention time of closed chest drainage tube, and improve the quality of life.
[1] 郑荣寿,陈茹,韩冰峰,等.2022年中国恶性肿瘤流行情况分析[J].中华肿瘤杂志,2024,46(3):221-231. ZHENG R S,CHEN R,HAN B F,et al.Cancer incidence and mortality in China,2022[J].Chin J Oncol,2024,46(3):221-231.(in Chinese) [2] 魏周斌,赵亮,张俣,等.胸腔镜肺楔形切除术与胸腔镜肺叶切除加纵隔淋巴结清扫术治疗早期非小细胞肺癌患者的临床效果比较[J].现代生物医学进展,2020,20(5):919-922. WEI Z B,ZHAO L,ZHANG Y,et al.Comparison of the clinical efficacy of thoracoscopic pulmonary wedge resection and thoracoscopic lobectomy plus mediastinal lymphadenectomy in the treatment of early non-small cell lung cancer[J].Prog Mod Biomed,2020,20(5):919-922.(in Chinese) [3] EDBROOKE L,GRANGER C L,DENEHY L.Physical activity for people with lung cancer[J].Aust J Gen Pract,2020,49(4):175-181. [4] 乔亚欣,杨慧,陈瑞云,等.肺癌术后患者运动康复依从性管理策略的研究进展[J].护理与康复,2023,22(11):94-98. QIAO Y X,YANG H,CHEN R Y,et al.Progress of research on strategies for managing adherence to exercise rehabilitation in postoperative lung cancer patients[J].J Nurs Rehabil,2023,22(11):94-98.(in Chinese) [5] MCCARRON E P,BAILEY M,LEONARD B,et al.Improving the uptake:barriers and facilitators to pulmonary rehabilitation[J].Clin Respir J,2019,13(10):624-629. [6] 陈雪姣,何昕.肺癌患者术后心理困扰现状及其影响因素分析[J].中华现代护理杂志,2021,27(24):3318-3322. CHEN X J,HE X.Current status of postoperative psychological distress in patients with lung cancer and its influencing factors[J].Chin J Mod Nurs,2021,27(24):3318-3322.(in Chinese) [7] 黄晓宇,耿明飞,周福有,等.吸气肌训练对食管癌根治术后患者心肺功能及生活质量的影响[J].中华物理医学与康复杂志,2017,39(7):539-542. HUANG X Y,GENG M F,ZHOU F Y,et al.Effects of inspiratory muscle training on cardiopulmonary function and quality of life in patients after radical esophagectomy for esophageal cancer[J].Chin J Phys Med Rehabil,2017,39(7):539-542.(in Chinese) [8] 苏建华,车国卫.肺癌患者术前肺功能评定的现状与进展[J].中国肿瘤临床,2017,44(7):301-305. SU J H,CHE G W.Current status and progress of preoperative pulmonary function evaluation in patients with lung cancer[J].Chin J Clin Oncol,2017,44(7):301-305.(in Chinese) [9] 余俊杰,陈宝钧,程晶,等.胸腔镜下肺段或肺叶切除术对老年非小细胞肺癌患者肺功能及血气指标的影响[J].中国老年学杂志,2024,44(14):3362-3366. YU J J,CHEN B J,CHENG J,et al.Effect of thoracoscopic segmental or lobectomy on lung function and blood gas index in elderly patients with non-small cell lung cancer[J].Chin J Gerontol,2024,44(14):3362-3366.(in Chinese) [10] 姜格宁,张雷,朱余明,等.肺切除手术患者术前肺功能评估肺科共识[J].中国胸心血管外科临床杂志,2020,27(1):1-9. JIANG G N,ZHANG L,ZHU Y M,et al.Pulmonary consensus on preoperative pulmonary function evaluation of patients undergoing pneumonectomy[J].Chin J Clin Thorac Cardiovasc Surg,2020,27(1):1-9.(in Chinese) [11] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组,中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会.慢性阻塞性肺疾病诊治指南(2021年修订版)[J].中华结核和呼吸杂志,2021,44(3):170-205. Chronic Obstructive Pulmonary Disease Group of Chinese Thoracic Society,Chronic Obstructive Pulmonary Disease Committee of Chinese Association of Chest Physician.Guidelines for the diagnosis and management of chronic obstructive pulmonary disease (revised version 2021)[J].Chin J Tuberc Respir Dis,2021,44(3):170-205.(in Chinese) [12] 中国老年保健协会肺癌专业委员会,四川省康复医学会加速康复外科分会,成都康复医学会肺康复专业委员会.肺癌围手术期肺康复训练中国专家共识[J].中国肺癌杂志,2024,27(7):495-503. Lung Cancer Specialty Committee of Chinese Elderly Health Care Association,Enhanced Recovery aster Surgery Specialty Committee of Sichuan Province Rehabilitation Medical Association,Lung Rehabilitation Specialty Committee of Chengdu Rehabilitation Medical Association.Chinese expert consensus on perioperative pulmonary rehabilitation training for lung cancer[J].Chin J Lung Cancer,2024,27(7):495-503.(in Chinese) [13] 马俏俏,罗静,郝桂华,等.肺癌患者术后1个月体力活动水平现状及影响因素分析[J].中华护理杂志,2024,59(16):1979-1987. MA Q Q,LUO J,HAO G H,et al.Analysis of the current state of physical activity levels and influencing factors in lung cancer patients a month post-surgery[J].Chin J Nurs,2024,59(16):1979-1987.(in Chinese) [14] 邓婷,宋佳美,李金,等.肺癌术后肺部并发症风险预测模型的研究进展[J].中国胸心血管外科临床杂志,2025,32(2):263-269. DENG T,SONG J M,LI J,et al.Research progress on risk prediction models of postoperative pulmonary complications after lung cancer surgery[J].Chin J Clin Thorac Cardiovasc Surg,2025,32(2):263-269.(in Chinese) [15] 都菁,邓海波,刘磊,等.主动呼吸循环技术对非小细胞肺癌手术患者心肺功能影响研究[J].护理学报,2021,28(21):71-74. DU J,DENG H B,LIU L,et al.Effect of active cycle of breathing technique on perioperative cardiopulmonary function of patients with non-small cell lung cancer[J].J Nurs China,2021,28(21):71-74.(in Chinese) [16] 冯霞,蔡小琼.慢性阻塞性肺疾病患者综合呼吸训练肺康复效果评价[J].预防医学,2019,31(7):703-706. FENG X,CAI X Q.Evaluation of pulmonary rehabilitation effects of comprehensive breathing training in patients with chronic obstructive pulmonary disease[J].China Prev Med J,2019,31(7):703-706.(in Chinese)
