图片式咳嗽指导法在肺癌手术患者中的应用

目的探讨图片式咳嗽指导法对肺癌患者术后呼吸道并发症发生率的影响。方法采用非同期临床对照试验将166例肺癌住院手术患者分为对照组和干预组，对照组在进行术前宣教时仅给予单纯的言语指导患者进行有效咳嗽，干预组则发放四步有效咳嗽法操作流程图，护理人员对照操作流程图对患者及其家属进行有效咳嗽指导。在手术当天术前评估患者咳嗽的有效性，术后记录患者呼吸道并发症的发生情况。结果干预组患者咳嗽的有效性非常满意的比例明显高于对照组（P〈0．01），一般满意及不满意的比例明显低于对照组（P〈0．01）；干预组患者术后肺不张、肺部感染和呼吸衰竭等呼吸道并发症的发生率明显低于对照组患者（P〈0．05）。结论图片式咳嗽指导法能有效提高肺癌患者咳嗽的有效性，减少术后呼吸道并发症的发生率。

Application of Picture Guided Cough Method in Patients Undergoing Lung Cancer Operation

Objective To study the effect of picture guided cough method on the occurrence of respiratory compli- cations of patients with lung cancer after surgery. Methods The nonsynchronous controlled clinical trials was performed. A total of 166 patients undergoing lung cancer operation were divided into intervention group and control group. The con- trol group was instructed by simple verbal guidance on effective cough in the preoperative education. The intervention group was given four steps of effective cough flow chart. The nursing personnel instructed the patients and their families to effectively cough according to the flow chart. The effectiveness of cough before operation was evaluated, and the inci- dence of postoperative respiratory complications was recorded. Results In the intervention group, the rate of ＂very satis- fied with the cough effectiveness＂ was significantly higher than that in the control group （P〈0. 01）, the rates of ＂general satisfaction＂ and ＂dissatisfaction＂ were significantly lower than those in the control group （P〈0. 01）. The incidence rates of respiratory tract complications including pulmonary atelectasis, pulmonary infection and respiratory failure, were sig- nificantly lower than those in the control group （P〈0. 05）. Conclusion Picture guided cough method can significantly im- prove the effectiveness of cough of patients with lung cancer after surgery, and reduce the incidence of postoperative re- spiratory complications.