Study On Effect Of Pulmonary Rehabilitation Training On Patients Undergoing Radical Surgery For Lung Cancer

Objectives:To observe the effects of exercise training combined with breathing training and simple breathing training in lung rehabilitation on the exercise capacity,dyspnea degree,maximum inspiratory volume,anxiety,depression,length of hospital stay,and length of postoperative thoracic closed drainage tube in patients undergoing radical surgery for lung cancer.Methods:This randomized controlled trial was performed in the Department of Thoracic Surgery,First Hospital of Jilin University from November 2017 to October2018.Patients with radical lung cancer surgery who met the exclusion criteria were randomly assigned to the exercise training combined breathing training group,the breathing training group,and the control group.The exercise training combined with the breathing training group received exercise training,breathing training and routine care during hospitalization.The content of the exercise training included climbing stairs and walking.The contents of the breathing training included Abdominal breathing,lip breathing,blowing balloons and inhale muscle training with a simple deep inhalation trainer(Voldyne 5000 Volumetric Exercise);Patients in the breathing training group receive respiratory training and routine care during hospitalization;Patients in the control group received only routine care during hospitalization.The primary outcome measures were exercise capacity,dyspnea,and inspiratory capacity.Secondary observations were anxiety,depression,length of hospital stay,and duration of postoperative thoracic closed drainage.The time of intervention was from the time the patient was admitted to the day the patient wasdischarged from the hospital.The collected data was analyzed using IBM SPSS Statistics 24.0 software.Results:1.A total of 150 patients were enrolled in the study.105 patients who met the exclusion criteria were included in the study.93 patients who underwent radical surgery for lung cancer were included in the study.Among them,31 patients under the combined exercise training group and the respiratory training group.For 30 patients,the control group was 32 patients.2.There were no significant differences in baseline data between age,gender composition,6-minute walking distance at admission,lung function,deep inspiratory volume,anxiety,depression,and dyspnea.3.After intervention during preoperative hospitalization,compared with the conventional nursing group,the 6-minute walking distance(P=0.002),the degree of dyspnea(P=0.003),the inspiratory capacity(P=0.037),anxiety(P<0.001),and depression(P<0.001)measured before the exercise training combined with the breathing training group were superior to the control group;In addition,the 6-minute walking distance(P<0.001),dyspnea(P=0.004),deep inspiratory capacity(P<0.001),and depression score(P=0.002)measured at the time of discharge from the exercise training combined with the respiratory training group.There were statistical differences compared with the control group.4.After intervention during preoperative hospitalization,the respiratory training group was superior to the control group in terms of inspiratory capacity(P = 0.044)compared with the conventional nursing group,and there was a statistical difference.However,there was no significant difference in 6-minute walking distance(P = 0.127),anxiety score(P = 0.949),and depression score(P = 0.696).;In addition,inspiratory capacity(P<0.001)and dyspnea(P = 0.027)measured at the time of discharge in the respiratory training group were superior to those in the control group,with statistical differences;However,there was no statistical difference in the 6-minute walking distance(P=0.288),anxiety score(P=0.628),and depression score(P=0.445)between preoperative and discharge compared with the control group.5.There were no statistical differences in the length of preoperative hospitalization(P=0.402)and postoperative hospital stay(P=0.137)in the three groups.There were no statistical differences in the length of the thoracic closed drainage tube(P=0.719)between the three groups.Conclusion:Exercise training combined with breathing training and Simple breathing training can significantly improve the maximum inspiratory capacity and dyspnea in patients undergoing radical lung cancer surgery.The combined training of exercise training combined with breathing training is significantly better than the simple breathing training.Compared with the control group,the exercise training combined with the breathing training group can also significantly improve exercise capacity,reduce anxiety and depression.However,the breathing training group had no difference in exercise ability,anxiety and depression compared with the control group.It is recommended to carry out lung rehabilitation training for patients undergoing radical surgery for lung cancer,and exercise training combined with breathing training as its best pulmonary rehabilitation training program to promote the early recovery of patients.