王龙平,谭金泽,郭霜,等.振动正压呼吸训练在新辅助化疗后食管癌术后患者中的应用[J].中华物理医学与康复杂志,2025,47(4):349-353
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| 振动正压呼吸训练在新辅助化疗后食管癌术后患者中的应用 |
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| DOI：10.3760/cma.j.cn421666-20240703-00544 |
| 中文关键词: 振动正压呼吸训练 咳嗽峰流速 加速外科康复 食管癌 |
| 英文关键词: Oscillating positive expiratory pressure training Peak cough flow Esophageal cancer Recovery after surgery |
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| 中文摘要: |
| 目的 观察振动正压呼吸训练对新辅助化疗后食管癌术后患者气道廓清能力的改善效果。 方法 募集符合入选条件的新辅助化疗后食管癌术后患者40例，按随机数字表将其分为对照组和试验组，每组患者20例。对照组于术后第一天开始进行常规康复干预，试验组在此基础上增加每日3次，连续5 d的振动正压呼吸训练。于术前、术后第一天、术后第三天、术后第五天检测2组患者的咳嗽峰流速（PCF）；于术前和术后第五天检测2组患者的第一秒用力呼气量（FEV1）、用力呼气量（FVC）和最大呼气峰流速（PEF）。 结果 术后第一天，2组患者的PCF较组内术前均显著下降（P<0.05）。术后第三天和第五天，2组患者的PCF较组内术后第一天均显著上升，且试验组术后第三和第五天的PCF均显著高于对照组同时间点，差异均有统计学意义（P<0.05）。术后第五天，2组患者的FEV1、FVC、PEF较组内术前均显著下降（P<0.05），术后第五天，试验组的FEV1和PEF分别为（2.22±0.51）L/s和（5.09±1.26）L/s，均显著高于对照组(P<0.05)。 结论 术后早期康复介入联合振动正压呼气训练可提高新辅助化疗后食管癌术后患者的咳嗽峰流速，改善气道廓清能力，促进术后肺功能的恢复。 |
| 英文摘要: |
| Objective To observe any effect of oscillating positive expiratory pressure training on the airway clearing ability of postoperative esophageal cancer patients after neoadjuvant chemotherapy. Methods Forty postoperative esophageal cancer patients undergoing neoadjuvant chemotherapy were enrolled and randomized into a control group and an experimental group, each of 20. Both groups received conventional postoperative rehabilitation starting on the first postoperative day, while the experimental group additionally underwent oscillating positive expiratory pressure training (3 sets/day, 30 breaths/set) for five consecutive days. Peak cough flow was measured using a peak flow meter before and 1, 3 and 5 days after the operation. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) were also measured on the 5th day after the operation using spirometry. Any postoperative pulmonary complications were recorded. Results On the 1st day after the operation, peak cough flow had decreased significantly in both groups compared to preoperative levels. However, it had increased significantly on days 3 and 5 in both groups, with the average increase in the experimental group significantly greater than in the control group. On day 5 the average FEV1, forced vital capacity and PEF in both groups were significantly lower than the preoperative values, while the experimental group demonstrated significantly higher average FEV1s (2.22±0.51L) and PEFs (5.09±1.26L/s) compared to the control group. Conclusions Early postoperative oscillating positive expiratory pressure training can improve the peak cough flow and airway clearing ability of esophageal cancer patients after neoadjuvant chemotherapy, promoting the recovery of their lung function. |
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