| Objective:Lung cancer is one of the most common malignant tumors in China.Non-small cell lung cancer(NSCLC)accounts for about 85% of all lung cancer patients,and the 5-year survival rate of advanced NSCLC patients is less than 5%.Surgery is still non the first choice of treatment for small lung cancer early stage(including ?,? and part of ?A)so far.With the continuous progress of medical science and technology,minimally invasive surgery has made great progress in surgical surgery,among which video-assisted thoracoscopic surgery is an important way to realize minimally invasive surgery.Although the application of video-assisted thoracoscopy in thoracic surgery has reduced the perioperative complications compared with the previous thoracotomy,the related complications are still very high.Pulmonary infection is one of the most common and serious postoperative complications in lung cancer patients.It is also a major factor leading to increased hospitalization costs and prolonged hospital stay,as well as an important cause of postoperative death in lung cancer patients.In this regard,there are many studies on the effect of preoperative lung function training on the improvement of patients' lung function.This series of studies believe that preoperative respiratory function training can reduce the incidence of postoperative pulmonary complications.But the line which is more beneficial to patients with respiratory function training,there is no unified solution in clinical application,and even the lack of a unified standard,this study will conduct a series of experimental comparison show that line preoperative respiratory trainer training blowing balloons line compared with preoperative respiratory function training in patients with respiratory function is more conducive to reducing postoperative hospital stay,lower the risk of postoperative pulmonary disease complications occurred.Methods:Selecting patients of Huaihe hospital of Henan university thoracic surgery form October2017 to May 2018,who blowing balloons preoperative respiratory function training under the thoracoscope lobectomy of surgical treatment of 90 patients,remove line pneumonectomy,combined lobectomy,sleeve resection,lung wedge resection and clinical data is imperfect,the final 62 routine under thoracoscope and pathological lung resection for non-small cell lung cancer patients in group A.Line breathing patients of pulmonary function training and line under the thoracoscope lobectomy of surgical treatment of 98 patients,remove line pneumonectomy,combined lobectomy,sleeve resection,lung wedge resection and clinical data is not perfect,will eventually under thoracoscope and postoperative pathologicallung resection for non-small cell lung cancer 73 patients in group B.all patients informed consent,voluntary clinical data including age sex body mass index,body mass index,BMI)smoking,drinking and the location of tumor,basis of preoperative chronic complications,such as chronic obstructive pulmonary disease(COPD)hypertension in type 2 diabetes,coronary heart disease,etc.)all of the patients in a hospital monitoring measurement related lung function index(FVC ? FEV1 ? PEF ? MVV)and respiratory function training after 1 week review of pulmonary function main indicators(FVC?FEV1?PEF MVV)related to compare postoperative indicators: surgical lung infection rate of postoperative bleeding amount of time to take time of postoperative hospital stay and postoperative pathology in clinical research for the statistical analysis,using SPSS 22.0 software measurement data to s said,compared with t test,the count data to n,% said,compared with chi-square test and inspection level of alpha = 0.05Results:(1)FVC,FEV1,PEF and MVV were compared between the two groups at admission.In group A,FVC,FEV1,PEF and MVV,the main indexes of lung function at admission and 1 week after training,were tested by t test,P < 0.001,with statistical significance(see Table 2 for details).FVC,FEV1,PEF and MVV were compared between the two groups at admission.In group B,FVC,FEV1,PEF and MVV,the main indexes of lung function at admission and 1 week after training,were tested by t test,P <0.001,with statistical significance(see Table 2 for details).At the time of admission,FVC,FEV1,PEF and MVV were the main lung function indicators of the two groups.After comparison between groups,the results showed that there was no statistically significant difference in major indicators of lung function between groups upon admission,indicating that the groups were comparable(see table 4 for details).The lung function indexes of FVC,FEV1,PEF and MVV in the two groups after 1 week of breathing training and before surgery were examined by t test,and the results were P <0.05,showing a statistical difference.(2)the indicators of postoperative surgery time of group A(160.15±47.53)min,intraoperative blood loss,ml(150.66 ± 30.87),postoperative complications,pulmonary infection,15 cases(24.2%),postoperative pulmonary leakage 9 cases(14.5%),7 cases(11.3%)of the tube again)with postoperative time(5.63 ±1.20),postoperative length of hospital stay(8.9±1.83)d,postoperative pathology(24 casesof squamous cell carcinomas(38.7%),adenocarcinoma,27 cases(43.5%),the other 11 cases(17.7%)).Group B operation time(162.85±58.54)min,intraoperative blood loss,ml(145.55±33.67),postoperative complications(10 cases of pulmonary infection(13.7%),6 cases of postoperative pulmonary leakage(8.2%),4 cases(5.5%)of the tube again)with postoperative time(5.12±1.21),postoperativelength of hospital stay(7.84 ± 2.22)d,postoperative pathological 25 cases of squamous cell carcinomas(34.2%),38 cases of adenocarcinoma(52.1%),and other 11 cases(13.7%).The operation time and intraoperative blood loss of the two groups were examined by t test,and the result was P > 0.05,showing no statistical difference.Postoperative catheter duration and postoperative hospital stay were tested by t test,results P<0.05 was a statistically significant difference.The postoperative pulmonary infection,postoperative air leakage,postoperative re-catheterization,and postoperative pathological conditions of the two groups were examined by 2 test,and the results showed no significant difference(P >0.05).To sum up,the results showed that there were no statistically significant differences in operation time,intraoperative blood loss,pulmonary infection,lung leakage,and postoperative re-catheterization between groups.Conclusion:(1)in patients undergoing thoracoscopic lobectomy,patients receiving 1 week of balloon blowing training before surgery and patients receiving 1 week of respiratory function training with respiratory trainer can both effectively improve the lung function indicators of patients.there was no statistical significance in the operation time,intraoperative blood loss,postoperative lung leakage,and postoperative re-catheterization.the respiratory function exercise with the respiratory trainer one week before the operation was compared with the exercise with balloon blowing before the operation,which reduced the postoperative catheter wearing time,postoperative pulmonary complication rate and postoperative hospital stay of patients with lung cancer.It can be seen that the preoperative exercise of respiratory trainer is more beneficial to the patient's postoperative recovery than the balloon exercise of respiratory function. |
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