自我效能加油站联合ACBT训练对非小细胞肺癌患者胸腔镜术后肺康复的影响

戴菲菲; 毛淑珍; 张咏梅

doi:10.16766/j.cnki.issn.1674-4152.003688

自我效能加油站联合ACBT训练对非小细胞肺癌患者胸腔镜术后肺康复的影响

doi: 10.16766/j.cnki.issn.1674-4152.003688

杭州市中医院胸心外科，浙江杭州 310007

基金项目:

浙江省医药卫生科技项目 2024KY1387

浙江省中医药科技计划项目 2023ZL517

详细信息

通讯作者:
戴菲菲，E-mail：knight99607@163.com

中图分类号: R734.2 R473.6
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出版历程
- 收稿日期: 2024-04-18

Effect of self-efficacy gas station combined with ACBT training on pulmonary rehabilitation of patients with non-small cell lung cancer after thoracoscopic surgery

Department of Thoracic and Cardiac Surgery, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310007, China

摘要

摘要: 目的探究自我效能加油站联合主动呼吸循环技术(ACBT)训练在非小细胞肺癌(NSCLC)患者胸腔镜术后肺康复中的应用效果，旨在为肺癌患者肺快速康复提供理论指导。方法选取2022年4月—2024年1月在杭州市中医院择期进行胸腔镜肺叶切除术治疗的NSCLC患者119例，采用Excel随机分为2组：对照组60例，采用常规肺康复训练；观察组59例，在对照组基础上采用自我效能加油站联合ACBT训练，直到术后3个月，比较2组自我效能、训练依从性、排痰量、肺功能及并发症发生率。结果对照组最终58例、观察组57例完成研究。观察组护理后自我效能量表(GSES)评分高于对照组(P＜0.05)；训练依从、主动寻求帮助依从及注意事项依从性评分均高于对照组(P＜0.05)；术后第3天排痰量多于对照组(P＜0.05)；第1秒用力呼气量/用力肺活量[FEV₁/FVC, (62.11±7.13)% vs.(58.09±6.09)%]、肺活量[VC, (3.40±0.91)L vs.(2.86±0.77)L]及呼气峰流速[PEF, (461.37±17.85)L/min vs.(422.34±20.09)L/min]参数均高于对照组(P＜0.05)；并发症发生率(3.51% vs.15.52%)低于对照组(P＜0.05)。结论自我效能加油站联合ACBT训练可提高NSCLC患者自我效能感和术后锻炼依从性，并促进排痰和术后肺功能恢复，减少并发症的发生。
- 非小细胞肺癌 /
- 自我效能加油站 /
- 主动呼吸循环技术 /
- 肺功能 /
- 并发症
Abstract: Objective To explore the application effect of self-efficacy gas station combined with active cycle of breathing techniques (ACBT) training in thoracoscopic postoperative pulmonary rehabilitation of patients with non-small cell lung cancer (NSCLC), in order to provide theoretical guidance for rapid pulmonary rehabilitation of patients with lung cancer. Methods A total of 119 patients with NSCLC who underwent thoracoscopic lobotomy in Hangzhou Hospital of Traditional Chinese Medicine from April 2022 to January 2024 were selected and divided into two groups by random excel method: 60 patients in control group received routine pulmonary rehabilitation training, and 59 cases in observation group received self-efficacy gas station combined with ACBT training on the basis of control group. Until 3 months after surgery, self-efficacy, training compliance, sputum output, lung function and complication rate of the two groups were compared. Results Fifty-eight patients in the control group and 57 patients in the observation group completed the study. The score of general self-efficacy scale (GSES) in observation group was higher than that in control group (P < 0.05). The scores of training compliance, help seeking compliance and precautions compliance were higher than those of control group (P < 0.05). The sputum output on the 3rd day after operation was higher than that of control group (P < 0.05). Forced expiratory volume/forced vital capacity [FEV₁/FVC, (62.11±7.13) % vs. (58.09±6.09) %], vital capacity [VC, (3.40±0.91) L vs. (2.86±0.77) L] and peak expiratory flow rate [PEF, (461.37±17.85) L/min vs. (422.34±20.09) L/min] parameters were higher than those in control group (P < 0.05). The complication rate (3.51% vs.15.52%) was lower than that of the control group (P < 0.05). Conclusion Self-efficacy gas station combined with ACBT training can improve the self-efficacy and postoperative exercise compliance of NSCLC patients, promote sputum excretion and postoperative lung function recovery, and reduce the occurrence of complications.
- Non-small cell lung cancer /
- Self-efficacy gas station /
- Active cycle of breathing techniques /
- Lung function /
- Complication
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表 1 2组NSCLC患者一般资料比较

Table 1. Comparison of general data of NSCLC patients between the two groups

组别	例数	性别(男/女，例)	年龄(x±s，岁)	BMI(x±s)	吸烟(例)	病理类型(腺癌/鳞癌/鳞腺癌，例)	病理分期(T1/T2，例)
对照组	58	36/22	59.09±5.12	22.34±2.27	18	38/7/13	41/17
观察组	57	34/23	59.14±6.77	22.56±3.09	21	42/9/6	44/13
统计量		0.071^a	0.045^b	0.437^b	0.433^a	3.021^a	0.631^a
P值		0.790	0.964	0.664	0.511	0.221	0.427
注：^a为χ²值，^b为t值。

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表 2 2组NSCLC患者护理前后GSES评分比较(x±s，分)

Table 2. Comparison of GSES scores before and after nursing of NSCLC patients between the two groups(x±s, points)

组别	例数	护理前	护理后
对照组	58	18.90±2.35	24.67±5.34^b
观察组	57	19.11±4.21	30.45±5.66^b
统计量		0.331^a	17.891^c
P值		0.741	＜0.001
注：^a为t值，^c为F值；与同组护理前比较，^bP＜0.05。

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表 3 2组NSCLC患者护理前后训练依从性评分比较(x±s，分)

Table 3. Comparison of training compliance scores of NSCLC patients before and after nursing between the two groups(x±s, points)

组别	例数	训练依从		主动寻求帮助依从		注意事项依从
组别	例数	护理前	护理后	护理前	护理后	护理前	护理后
对照组	58	11.78±2.45	16.99±3.22^b	7.12±1.23	10.34±2.45^b	8.90±1.34	13.22±3.12^b
观察组	57	11.45±2.17	20.91±4.77^b	6.98±1.02	13.45±2.11^b	9.12±2.44	15.88±3.09^b
统计量		0.764^a	20.091^c	0.664^a	16.231^c	0.601^a	18.921^c
P值		0.446	＜0.001	0.508	＜0.001	0.549	＜0.001
注：^a为t值，^c为F值；与同组护理前比较，^bP＜0.05。

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表 4 2组NSCLC患者术后第1天及第3天排痰量比较(x±s，g)

Table 4. Comparison of sputum output on day 1 and day 3 of postoperative NSCLC between the two groups(x±s, g)

组别	例数	术后第1天	术后第3天
对照组	58	4.56±0.77	10.09±2.44^b
观察组	57	4.80±0.95	14.67±3.10^b
统计量		1.490^a	17.541^c
P值		0.139	＜0.001
注：^a为t值，^c为F值；与同组术后第1天比较，^bP＜0.05。

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表 5 2组NSCLC患者护理前后肺功能指标比较(x±s)

Table 5. Comparison of pulmonary function indexes of NSCLC patients before and after nursing between the two groups(x±s)

组别	例数	FEV₁/FVC(%)		VC(L)		PEF(L/min)
组别	例数	护理前	护理后	护理前	护理后	护理前	护理后
对照组	58	54.67±5.22	58.09±6.09^b	2.09±0.78	2.86±0.77^b	361.09±14.56	422.34±20.09^b
观察组	57	54.34±6.10	62.11±7.13^b	2.13±0.85	3.40±0.91^b	359.91±15.12	461.37±17.85^b
统计量		0.312^a	19.092^c	0.263^a	16.341^c	0.426^a	20.015^c
P值		0.756	＜0.001	0.793	＜0.001	0.671	＜0.001
注：^a为t值，^c为F值；与同组护理前比较，^bP＜0.05。

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表 6 2组NSCLC患者并发症发生率比较[例(%)]

Table 6. Comparison of complication rate of NSCLC patients between the two groups[cases(%)]

组别	例数	肺不张	低氧血症	肺部感染	胸腔积液	总计
对照组	58	2(3.45)	2(3.45)	3(5.17)	2(3.45)	9(15.52)
观察组	57	1(1.75)	0	1(1.75)	0	2(3.51)
χ²值		< 0.001	0.491	0.241	0.491	4.792
P值		0.988	0.483	0.623	0.483	0.029
注：同一患者未出现≥2种并发症。

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