Objective:To investigate the impact of active cycle of breathing technique(ACBT) and conventional air way clearance therapy(percussion and vibration) on fast track recovery after pulmonary lobectomy for non-small cell lung cancer.Method:A total of 78 lung cancer patient were chosen from 106 lung cancer patient admitted to Guangdong general hospital between January 2016 and January 2017.During study period,two patients dropped out in each group and 74 patients were included in the analysis finally.They were randomly allocated into experimental group (experimental group,37 patients including 23 males and 14 females with their average age of 56.05± 10.57 years)and control group (control group,37 patients including 21 males and 16 females with their average age of 59.35±10.57 years).There was no statistical difference in preoperative clinical characteristics.Patients in the control group had routine postoperative percussive and vibration chest physiotherapy ten minutes for every time,twice a day.Participants in the ACBT group received ACBT treatment for twice a day,6-8 cycle every time after surgery.The total hospital stay,postoperative hospital stay,length of chest tube removal and recovery level of cardiopulmonary function were compared between the 2 groups.Result:The length of chest tube removal of experiment group were significantly less than that of control group (1.41±0.60 vs 2.84±1.07 P＜0.05).Patients in the ACBT group showed significant improvement in cardiopulmonary function assessed by 6MWD and the less change in pulmonary function(FEVI and FVC) relative to the preoperation on the fourth day after surgery (377.46±67.95 vs 328.48±89.17,0.55±0.38 vs 1.03±0.45,0.84±0.20 vs 1.22±0.48,P＜0.05).Although the total hospital stay and postoperative hospital stay of experiment group were less than the control group(11.76±3.56 vs 13.73±4.90,5.56±2.64 vs 6.16±2.40,P＞0.05,there was no statistical difference.Conclusion:Compared with conventional air way clearance therapy(percussion and vibration),the ACBT can shorten the length of chest tube removal and promote the recovery of postoperative cardiopulmonary function,which is helpful for fast track recovery of NSCL patient after pulmonary lobectomy.%目的:探讨主动呼吸循环技术与传统的呼吸道管理技术(扣拍、震动)相比对非小细胞肺癌肺叶切除术后患者康复的影响.方法:2016年1月-2017年1月在广东省人民医院肺外科住院患者中募集到106例肺癌患者,将符合条件的非小细胞肺癌肺叶切除术后的78例患者随机分成试验组和对照组,两组中分别有2例患者中途退出,共有74例患者纳入分析.其中试验组37例,男23例、女14例,年龄(59.05±10.57)岁;对照组,37例,男21例,女16例,年龄(53.95±12.59)岁.两组患者的临床特征差异无显著性意义.试验组与对照组相比,在术后常规的物理治疗基础上,将传统的2次/天,10min/次的扣拍震动,换成2次/天,每次6-8个循环的主动呼吸循环技术.比较两组患者术后的拔管天数、术后住院天数、住院总天数、心肺功能恢复的程度.结果:试验组术后的拔管天数要小于对照组(1.41±0.60 vs 2.84±1.07,P＜0.05),术后第4天的6min步行距离试验组大于对照组(377.46±67.95 vs 328.48±89.17,P＜0.05),术后第4天FEV1和FVC与术前相比改变值试验组要小于对照组,分别是(0.55±0.38 vs 1.03±0.45,P＜0.05;0.84±0.20 vs 1.22±0.48,P＜0.05),虽然术后住院天数和总住院天数试验组小于对照组,分别是(11.76±3.56 vs 13.73±4.90,P=0.054)、(5.56±2.64 vs 6.16±2.40,P=0.315),差异无显著性意义.结论:与传统的呼吸道管理技术相比,应用主动呼吸循环技术可以缩短非小细胞肺癌肺叶切除术后患者的拔管天数,促进术后心肺功能的恢复,从而起到快速康复的作用.
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