The Study On The Postoperative Effect Of Systematic Respiratory Function Training For The Elderly Pulmonary Cancer Patients

Background Along with the extension of the average life expectancy, lung cancer has gradually increased in elderly patients, and besides, morbidity and mortality rates showed an upward trend. With the advancement of surgical techniques and anesthesia techniques, clinical treatment of lung cancer in elderly patients is still focused on surgery as a primary means. However, surgical treatment has a serious influence on the rehabilitation effect of older patients with lung cancer, which can cause postoperative respiratory function declining, and complications such as atelectasis, lung infection and respiratory failure. Respiratory function training plays a role of enhancing the contraction degree of respiratory muscle, eliminating ineffective function of secondary respiratory muscles, reducing the oxygen consumption of respiratory muscles and increasing the purge-recovery capacity of airway, so it is an effective method of improving postoperative lung function, decreasing postoperative complications and reducing indwelling time of chest tube and the course of disease.Objective Through comparing postoperative respiratory function status, pulmonary complication rates, chest tube retention time and days of hospitalization after operation between experimental group and control group to evaluate the influence of respiratory function training methods on the rehabilitation effect of elderly pulmonary cancer patients after operation.Methods This is an experimental study. Guided by the theory of "Respiratory function retraining based on the anatomy and physiology", we collected 60 cases in Cardio-thoracic Surgery Ward in Nantong University Affiliated Hospital by convenience sampling method and randomly divided them into experimental group and control group in accordance with random number table. Routine care was given by nurses to the control group, while one to one intervention was given by researcher to the experimental group, which is a respiratory function training system composed of effective cough training, abdominal breathing, lip-shrinking breathing and segmental breathing, besides routine care was also given by nurses to experimental group. Patients' postoperative pulmonary function status is measured by several indexes, including three lung function indicators, that is subjective respiratory dysfunction from the second to the seventh days after operation, Vital Capacity percentage of the predicted value (VC%), Forced Vital Capacity percentage of the predicted value (FVC%), Forced Expiratory Volume of the first second percentage of the predicted value (FEV1%), and the indicators in the blood gas analysis, that is the PaO₂ and PaCO₂ level. The effect of the intervention method on rehabilitation is synthetically measured by a combination of those indicators mentioned in the last sentence and some other issues, including postoperative pulmonary complications, chest tube retention time and hospitalization days after operation.Results Subjective respiratory dysfunction from the third to the seventh day was significantly different in the two groups (p<0.05), while there was no difference on the second day; The three indicators of pulmonary function, including VC%, FVC% and FEV1% showed a significant difference on the third and the seventh day (p<0.05); The PaO₂ was significantly different between the two groups (p<0.05), but the PaCO₂ not (p>0.05); The rate of complication occurrence is 3.33% in experimental group and 30% in control group, so significant difference can be found between two groups in aspect of pulmonary complications; Chest tube retention time and hospitalization days were both significantly different between two groups (p<0.05).Conclusion The systematic respiratory function training, including abdominal breathing, lip-shrinking breathing, effective cough training and segmental breathing can effectively improve rehabilitation effect of elderly pulmonary tumor patients after operation, which means it is effective in mending respiratory function of patients, reducing chest tube retention time and hospitalization time and decreasing complication occurrence.