围手术期视频宣教模式呼吸操对胸腔镜下肺癌手术患者的影响

【摘要】目的评估围手术期医患互通结合视频宣教模式呼吸操训练对行胸腔镜下肺癌手术患者手术效果及术后并发症的影响。方法选取2019年4月至8月在江苏省人民医院胸外科将行胸腔镜下肺癌切除术的208例患者,随机分为对照组及干预组,每组104例。对照组给予常规围手术期护理,干预组除常规护理,于术前5～8 d及出院后10 d给予医患互通结合视频宣教模式呼吸操训练,对比两组患者术后住院、胸腔引流管留置时间及术后肺部并发症发生情况。结果干预组患者术后住院时间短于对照组[（4.01±1.27）d vs. （4.46±1.53）d],引流管留置时间也短于对照组[（2.57±1.16）d vs. （3.18±1.75）d],差异均有统计学意义。干预组患者术后30 d内肺部并发症总发生率较对照组降低（19.2% vs.37.5%）,差异有统计学意义;但两组肺不张（0.9% vs. 0.9%）、胸腔积液（7.7% vs. 5.8%）发生率差异无统计学意义。结论围手术期医患互通结合视频宣教模式呼吸操训练能缩短手术患者的住院时间及引流管留置时间,减少术后并发症,促进患者快速康复。

Effect of perioperative video-mission mode breathingexercise on patients with thoracoscopic lung cancer surgery

Background and objective ：Thoracoscopic resection is an important method for the treatment of patients with early stage lung cancer. The aim of this study was to evaluate the impact of perioperative doctor-patient combined with video-mission mode breathing exercise (Doctor Lu's breathing exercises) on patients undergoing thoracoscopic lung cancer resection. Methods：250 patients receiveing thoracoscopic lung cancer resection in Department of Thoracic Surgery,Jiangsu Province Hospital were randomly divided into control group(CG) and intervention group(IG). The CG received routine perioperative nursing. The IG received routine perioperative nursing and Doctor Lu's breathing exercises for 5-8 days before surgery and 10 days after discharge. The differences between the two groups of postoperative hospital stay, chest drainage tube indwelling time, postoperative pulmonary complications(PPCS) were compared.Results:The total incidence of PPCS in the IG was lower than that in the CG within 30 days after surgery (19.2% vs 37.5%, P=0.03),there was no significant difference in the incidence of atelectasis (0.9% vs 0.9%, P=1) and hydrothorax (7.7% vs 5.8%, P=0.580).The postoperative hospital stay [(4.01±1.27)d vs (4.46± 1.53)d,P=0.022] and extubation time [(2.57 ±1.16)d vs (3.18± 1.75)d,P=0.003]in the IG were shorter than in the CG;Conclusion:Perioperative doctor-patient combined with video-mission mode breathing exercises can shorten thelenghth of stay and extubation time of the patients, reduce the complications and sequelae of the patients, and promote the rapid recovery of the patients.