The Effect Of Preoperative Pulmonary Rehabilitation In Patients With Lung Cancer Undergoing Video-assisted Thoracoscopic Lobectomy

Objective To explore the effect of preoperative pulmonary rehabilitation in patients with lung cancer undergoing video-assisted thoracoscopic lobectomy.Methods A retrospective analysis of our hospital of 64 consecutive cases of video-assisted thoracoscopic lobectomy for lung cancer patients with clinical data from January 2014 to May 2017,including preoperative pulmonary rehabilitation(PR group)and non-preoperative Pulmonary rehabilitation of patients(NPR group)of the 32 cases,respectively,corresponding respectively to compare two groups of patients in length of postoperative stay,chest tube removal duration,the incidence of atelectasis,pleural puncture rate again,postoperative pulmonary complications and the pulmonary function,arterial blood gas analysis and stair-climbing test were taken before and after the training of PR group.Results There were 32 cases of preoperative pulmonary rehabilitation,compared with the NPR group,the mean postoperative length of stay [(8.56 + 2.20)d vs.(12.41 + 2.51)d,t=-6.512,P=0.000],the incidence of postoperative pulmonary complications [18.75%(6/32)vs.43.75%(14/32),c2=4.267,P=0.031],pulmonary infection[12.5%(4/32)vs.34.4%(11/32),c2=4.267,P=0.039],atelectasis [12.5%(4/32)vs.37.5%(12/32),c2=20.536,P=0.000],and chest tube removal duration [(5.41 + 1.72)d vs.(9.28 + 2.71)d,t=-6.821,P=0.000] were significantly reduced in the PR group.Hever,there was no significant difference in pleural puncture again [9.37%(3/32)vs.28.13%(9/32),c2=3.692 P=0.055].Stair climb time T(49.87 + 8.32 s vs.47.78 + 8.20 s,t=9.647,P=0.000),and Borg index(6.75 + 2.02 vs.5.09 + 1.53,t=8.128,P=0.000)were statistically significant difference in PR group before and after training.But the change of heart rate and heart P(49.73±7.97time/min vs.50.03±8.07 time/min,t=-1.075,P= 0.291)and oxygen saturation percentage change ?SPO2%(5.25±2.53% vs.4.21±2.03%,t=1.568,P= 0.127)had no significant difference.In PR group before and after training,there was no significant difference in FEV1(2.11 + 0.41 L vs.2.29 + 0.51L),FVC(2.89 + 0.54 L vs.2.75 + 0.59L),FEV1/FVC(74.88 + 9.10 vs.76.87 + 6.70),MVV(87.77±20.06 L/min vs.87.33±15.22 L/min),DLCO(7.48±1.54 mol/min/Kpa vs.7.63±1.23 mol/min/Kpa),SPO2(60.53±4.83 mm Hg vs.62.24±5.31 mm Hg),Pa CO2(38.38±3.24 mm Hg vs.39.19±2.92 mm Hg).No deaths occurred in the PR groups at 30days after operation,In PR group,one patient died in pulmonary embolism.Conclusion For lung cancer patient undergoing video-assisted thoracoscopic lobectomy,pulmonary rehabilitation program lasting 4 weeks was considered may be shorten postoperative length of stay,reduce postoperative pulmonary complications,decrease postoperative intubation time,improve thoracoscopic lobectomy patients tolerance,and can be used to carry out according to the actual situation of different units.