Effect of comprehensive lung rehabilitation training on lung function and syndrome in patients with lung cancer undergoing radiotherapy
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摘要:
目的 探究肺综合康复训练对肺癌放疗患者肺功能、癌因性疲乏及症状、生活质量的影响。 方法 连续纳入2018年6月—2019年6月于宁波市医疗中心李惠利医院行放疗的肺癌患者87例,利用随机数字表法分为观察组(44例)和对照组(43例),对照组采用常规放疗管理和院外管理,观察组在对照组基础上进行肺综合康复训练,持续24周,比较2组干预前后肺功能、癌因性疲乏[Piper疲乏修正量表(PFS-R)]、放疗相关症状[记忆症状评估量表(MSAS)]以及生活质量[欧洲癌症患者生活质量核心量表(EORTCQLQ-C30)]。 结果 干预后,观察组FEV1百分比预测值为(90.37±2.18)%、FVC百分比预测值为(93.65±2.20)%,MVV百分比预测值为(87.67±2.59)%,对照组上述指标分别为(87.33±2.38)%、(88.36±2.27)%、(83.47±2.19)%,2组比较差异有统计学意义(均P<0.05)。观察组PFS-R评分为(4.58±0.60)分,低于对照组的(5.17±0.65)分(t=4.401,P<0.05)。观察组咳嗽症候评分为(1.02±0.18)分,低于对照组的(1.78±0.23)分(t=17.186,P<0.05),2组食欲下降评分比较差异无统计学意义(t=0.491,P>0.05)。干预后,观察组躯体维度、情绪维度和社会维度评分均高于对照组(均P<0.05),2组角色维度和认知维度比较差异无统计学意义(均P>0.05)。 结论 肺综合康复训练能够提高肺癌放疗患者肺通气功能,减轻癌因性疲乏以及咳嗽症状,提高生活质量。 Abstract:Objective To explore the effect of comprehensive lung rehabilitation training on lung function, cancer-related fatigue, symptoms and quality of life in patients with lung cancer undergoing radiotherapy. Methods Eighty-seven lung cancer patients who received radiotherapy in Li Huili Hospital of Ningbo Medical Center from June 2018 to June 2019 were included in this study. They were divided into the observation group (44 cases) and control group (43 cases). The control group used conventional radiotherapy management and out-of-hospital management. The observation group used combined comprehensive lung rehabilitation training on the basis of the control group for 24 weeks. Lung function, cancer-related fatigue (PFS-R), MSAS and EORTCQLQ-C30 were compared before and after the intervention. Results After intervention, the predictive values of preFEV1%, preFVC% and preMVV% were (90.37±2.18)%, (93.65±2.20)% and (87.67±2.59)%, respectively, whereas those of the control group were (87.33±2.38)%, (88.36±2.27)% and (83.47±2.19)%, respectively, and the difference was statistically significant (P < 0.05). The PFS-R score of the observation group (4.58±0.60) was lower than that of the control group (5.17±0.65, t=4.401, P < 0.05). The score of cough syndrome in the observation group was 1.02±0.18, which was lower than that in the control group (1.78±0.23, t=17.186, P < 0.05). No significant difference in the score of appetite decline was found between the two groups (t=0.491, P>0.05). After intervention, the scores of physical dimension, emotional dimension and social dimension in the observation group were higher than those in the control group (all P < 0.05), and no significant difference in role dimension and cognitive dimension was found between the two groups (all P>0.05). Conclusion Comprehensive lung rehabilitation training can improve lung ventilation function and quality of life relieve cancer-related fatigue and cough symptoms, and improve quality of life. -
表 1 2组NSCLC术后放疗患者基线资料比较(例)
组别 例数 性别 年龄(x±s, 岁) 临床分期 合并疾病 男性 女性 Ⅰ期 Ⅱ期 Ⅲa期 高血压 冠心病 糖尿病 观察组 44 30 14 64.37±6.58 17 21 6 5 3 8 对照组 43 25 18 65.24±6.69 14 24 5 7 2 5 统计值 0.943a 0.616b 0.358c 0.442a 0.001a 0.735a P值 0.332 0.542 0.721 0.506 0.979 0.391 注:a为χ2值,b为t值, c为Z值。 表 2 2组NSCLC术后放疗患者肺功能比较(x±s,%)
组别 例数 FEV1 FVC MVV 干预前 干预后 干预前 干预后 干预前 干预后 观察组 44 78.94±2.16 90.37±2.18a 80.77±3.27 93.65±2.20a 77.95±2.38 87.67±2.59a 对照组 43 78.67±2.06 87.33±2.38a 81.25±3.32 88.36±2.27a 78.04±2.43 83.47±2.19a t值 0.596 6.215 0.679 11.038 0.174 8.159 P值 0.552 <0.001 0.499 <0.001 0.862 <0.001 注:与同组干预前比较,aP<0.05。 表 3 2组NSCLC术后放疗患者癌因性疲乏及放疗症候群比较(x±s,分)
组别 例数 PFS-R 咳嗽症候MSAS 食欲下降症候MSAS 干预前 干预后 干预前 干预后 干预前 干预后 观察组 44 5.30±0.77 4.58±0.60a 2.07±0.28 1.02±0.18a 1.53±0.28 1.45±0.18 对照组 43 5.35±0.74 5.17±0.65 2.10±0.30 1.78±0.23a 1.55±0.26 1.47±0.20 t值 0.309 4.401 0.482 17.186 0.345 0.491 P值 0.758 <0.001 0.631 <0.001 0.731 0.625 注:与同组干预前比较,aP<0.05。 表 4 2组NSCLC术后放疗患者EORTCQLQ-C30评分的比较(x±s,分)
组别 例数 躯体维度 情绪维度 角色维度 认知维度 社会维度 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 观察组 44 65.48±10.27 78.76±11.03a 66.38±10.27 76.93±10.67a 68.93±11.20 72.39±10.28a 64.38±9.84 68.37±10.11a 69.32±8.27 88.76±9.05a 对照组 43 65.72±10.73 72.39±10.83a 65.83±10.83 70.93±11.20a 69.04±11.02 73.09±10.56a 65.02±10.17 68.03±10.20a 70.12±8.73 76.36±9.14a t值 0.107 2.717 0.243 2.559 0.214 0.313 0.298 0.156 0.439 6.358 P值 0.915 0.008 0.809 0.012 0.831 0.755 0.766 0.876 0.662 <0.001 注:与同组干预前比较,aP<0.05。 -
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