反馈式呼吸电刺激训练对肺癌术后患者膈肌运动和肺功能的影响

关键词：肺癌  手术  电刺激  膈肌功能  肺功能  超声

Keywords:lung cancer  resection  electrical stimulation  diaphragmatic function  pulmonary function  ultrasound

摘要：

      摘要 目的：探讨反馈式呼吸电刺激训练对肺癌术后患者膈肌运动和肺功能的影响。 方法：将30例肺癌术后患者按随机数字表分为试验组和对照组，每组各15例。试验组在常规护理基础上给予反馈式呼吸电刺激训练,对照组接受常规护理和腹式呼吸训练，呼吸训练强度均为20min/次,3次/周,共4周。两组患者均于训练前、训练4周后、术后3个月时完成M型超声下观察平静呼吸、深吸气2种呼吸状态时的双侧膈肌运动幅度和肺功能检测。肺功能观察指标包括用力肺活量（forced vital capacity, FVC）、第一秒用力呼气容积(forced expiratory volume in first second,FEV1)及其各自占预测值的百分比。 结果：训练4周后，两组患者膈肌运动幅度和肺功能均较基线值改善，但与对照组比较，试验组的FVC、FEV1%、FVC%、平静呼吸和深吸气时的术侧膈肌运动幅度改善程度更显著（P<0.05）；在术后3个月，试验组的FVC、FEV1%、深吸气时的双侧膈肌运动幅度均较对照组增加，差异具有显著性意义（P<0.05）。 结论：反馈式呼吸电刺激训练可以改善肺癌术后患者的膈肌运动和肺功能。

Abstract:

      Abstract Objective: To study the effect of respiratory electrical stimulation training with biofeedback on the diaphragmatic motion and respiratory function for the patients with lung cancer after pulmonary resection. Method: Thirty patients following pulmonary lobectomy were randomly divided into experimental group (n=15) and control group (n=15). In addition to routine postoperative care，the experimental group received a 4-week respiratory electrical stimulation training with biofeedback using an electric stimulus feedback trainer（20mins per time,3 times per week）.The control group received postoperative routine nursing and abdominal breath training（20mins per time,3 times per week）. Diaphragmatic motion and respiratory function of 2 groups were tested before and after the training. M-mode ultrasonography was used to observe bilateral diaphragmatic moving range during quiet breathing and deep breathing. The pulmonary function tests included forced vital capacity(FVC), forced expiratory volume in first second ( FEV1) and its percentage of predicted value. Result: After 4 week training,the value of diaphragmatic motion and respiratory function both improved，compared to the baseline value. Respiratory function of the training group was significantly greater than that of the control group, and diaphragmatic moving range on the operation side during quiet breathing and deep breathing of the training group was significantly higher than that of the control group(P<0.05）.3 months after the resection, FVC%,FEV1% and diaphragmatic moving range on both side during deep breathing were more obvious in experimental group，compared to control group（P<0.05）． Conclusion: Respiratory electrical stimulation training with biofeedback can improve pulmonary function and diaphragmatic motion function of the patients following pulmonary lobectomy．