目的:缺乏标准化方案和教育是围手术期肺康复(PR)的主要障碍,特别是对于具有术后肺部并发症(PPCs)高危因素的患者。我们旨在探讨混合结构肺康复教育计划(SPREP)对PPC高危肺癌患者的影响。
方法:进行了具有前后测试设计的准实验试验。对照组(n=53)采用常规围手术期肺部康复,而干预组(n=53)接受SPREP。呼吸功能,6分钟步行距离,Borg呼吸困难量表,生活质量,入院时的焦虑抑郁评分,放电,出院后2周3个月,比较两组患者PPC发生率。
结果:两组出院时6分钟步行距离和Borg呼吸困难评分比较差异无统计学意义(P>0.05)。而干预组在其余时间点表现改善(P<0.05)。此外,干预组的运动能力有所提高,肺功能和生活质量,出院时焦虑和抑郁程度降低,出院后2周和出院后3个月(P<0.05)。此外,干预组PPC的发生率明显降低,尤其是术后肺炎.
结论:SPREP在提高运动能力方面可能显示出显著的益处,肺功能,和生活质量,同时减少PPC的发生并减轻焦虑和抑郁的水平,未来大型RCT的疗效有待进一步探讨。
背景:本研究在中国临床试验注册中心(ChiCTR)注册,注册号为[ChiCTR2200066698]。
OBJECTIVE: The absence of standardized protocols and education are the main obstacles to perioperative pulmonary rehabilitation (PR), especially for patients with high-risk factors of postoperative pulmonary complications (PPCs). We aimed to explore the effect of a hybrid structured pulmonary rehabilitation education program (SPREP) on patients with lung cancer at high risk of PPCs.
METHODS: A quasi-experimental trial with a pre-post test design was conducted. The control group (n = 53) adopted routine perioperative pulmonary rehabilitation, while the intervention group (n = 53) received SPREP. Respiratory function, 6-min walk distance, Borg dyspnea scale, quality of life, anxiety-depression scores at admission, discharge, 2 weeks and 3 months post-discharge, and incidence of PPCs were compared between the two groups.
RESULTS: There were no significant differences on the 6-min walk distance and Borg Dyspnoea Scale at discharge between the two groups (P > 0.05), whereas the intervention group showed improved performance at the remaining time points (P < 0.05). In addition, the intervention group had improved exercise capacity, pulmonary function and quality of life, reduced levels of anxiety and depression at discharge, 2 weeks post-discharge and 3 months post-discharge (P < 0.05). In addition, incidence of PPCs was significantly reduced in the intervention group, especially postoperative pneumonia.
CONCLUSIONS: The SPREP could show significant benefits in enhancing exercise capacity, lung function, and quality of life, while diminishing the occurrence of PPCs and mitigating the levels of anxiety and depression, future large RCT need to further explore the efficacy.
BACKGROUND: This study was registered with the China Clinical Trial Registration Center (ChiCTR) under the Clinical Trial Registration Number [ChiCTR2200066698].