综合物理治疗对肺癌合并慢性阻塞性肺疾病患者术后肺功能的影响

发布时间：2018-06-12 01:49

  本文选题：物理治疗 + 肺癌　； 参考：《中国呼吸与危重监护杂志》2017年04期

【摘要】：目的评估综合物理治疗对肺癌合并慢性阻塞性肺疾病(简称慢阻肺)患者肺切除术或叶切除术后肺功能的影响。方法选取2005年1月至2014年5月因肺癌接受肺切除术或肺叶切除术的慢阻肺合并肺癌患者,根据术前是否接受物理治疗分为综合物理治疗组(A组,55例)和未接受综合物理治疗组(B组,43例)。比较A组入院时(T1时间点)和综合物理治疗后(T2时间点)的肺功能的变化,同时比较A、B两组患者手术后(T3时间点)肺功能和临床特征的变化。结果 A组患者进行术前综合物理治疗后第1秒用力呼气容积(FEV_1)、肺活量(VC)、50%肺活量位最大呼气流速(FEF50)和25%肺活量位最大呼气流速(FEF25)比基线值分别增加16.96%、14.75%、20.69%和13.79%,6分钟步行距离得到显著改善。术后FEV_1和VC显著降低,小气道功能和临床特征显著恶化,在Δ[T2-T1]阶段,不同程度FEV_1%pred患者间肺功能变化差异无统计学意义;在Δ[T2-T3]阶段,FEV_1%pred≥80%患者和50%≤FEV_1%pred80%患者FEF50和FEF25变化程度大于FEV_1%pred50%的患者。肺叶切除术患者肺功能B组患者低于A组患者(FEV_1:10.24%vs.22.44%;VC:10.13%vs.20.87%);在肺切除术患者中也存在相似的差异,但差异较小(FEV_1:36.33%vs.36.78%;VC:37.23%vs.38.98%)。结论综合物理治疗对于改善肺癌合并慢阻肺患者肺切除术或叶切除术后肺功能有重要意义。
[Abstract]:Objective to evaluate the effects of comprehensive physical therapy on pulmonary function in patients with lung cancer complicated with chronic obstructive pulmonary disease (COPD) after pneumonectomy or lobectomy. Methods from January 2005 to May 2014, patients with COPD complicated with lung cancer underwent pneumonectomy or lobectomy. According to whether the patients received physical therapy before operation, they were divided into two groups: group A (55 cases) and group B (43 cases). To compare the changes of pulmonary function between group A and group A (T 1) and T 2 after comprehensive physical therapy, and to compare the changes of lung function and clinical features between group A and group A (P < 0.05). Results in group A, forced expiratory volume (FEV 1), maximal expiratory flow rate (VEF 50%) and maximal expiratory flow rate (FEF25) in 25% vital capacity position were increased by 16.96 ~ 14.75% and 13.79 ~ 6 minutes, respectively, compared with baseline values. The distance between rows has been improved significantly. FEV1 and VC decreased significantly and the small airway function and clinical features deteriorated significantly after operation. There was no significant difference in pulmonary function between patients with FEV _ 1pred at 螖 [T2-T1] stage. In the stage of 螖 [T2-T3], FEV1Pred 鈮，

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