肺癌患者围手术期振动正压呼气训练有助于加速康复吗？

BACKGROUND AND OBJECTIVE: Oscillatory positive expiratory pressure (OPEP) training is a kind of breathing exercise with Acapella. The clinical value of OPEP has been widely discussed in chronic obstructive pulmonary disease, bronchiectasis as well as pulmonary cyst. However, few studies have explored the application of OPEP in surgery lung cancer patients underwent lobectomy. Thus, the aim of this study is to explore the impact of the application of OPEP device (acapella) in lung cancer patients undergoing video-assisted thorascopic surgery (VATS). METHODS: Sixty-nine patients receiving VATS lobectomy in Department of Thoracic Surgery, West China Hospital, Sichuan University from September 15, 2017 to January 15, 2018 were randomly divided into the acapella group (AG) or the control group (CG). The patients in the AG received oscillating positive expiratory pressure training and the CG underwent standard perioperative treatment. The differences of morbidity, pulmonary function, quality of life were compared between the two groups. RESULTS: Thirty-five patients were assigned to the AG and thirty-four patients were assigned to the CG. The incidences of postoperative pulmonary complications (PPCs) and atelectasis (2.9%, 0.0%) in the AG were significantly lower than that in the CG (20.6%, 14.7%)(P=0.03, P=0.03). The duration of total hospital stay and postoperative hospital stay in the AG (10.86±5.64, 5.09±4.55) d were significantly shorter than that in the CG (10.86±5.64, 5.09±4.55) d (P=0.01, P=0.01). The drug cost in the AG (4, 413.60±1, 772.35) ￥ were significantly lower than that in the CG (6, 490.35±3, 367.66) ￥ (P=0.01). The patients in the AG had better forced expiratory volume in the first second and peak expiratory flow [(1.50±0.32) L, (252.06±75.27) L/min] compared with the CG [(1.34±0.19) L, (216.94±49.72) L/min] (P=0.03, P=0.03) at discharge. CONCLUSION: The application of OPEP device during the perioperative period was valuable in decreasing PPCs and enhancing recovery for lung cancer patients receiving VATS lobectomy.