目的

评估术前呼吸功能锻炼是否会降低食管癌术后肺部感染的发生率，促进患者的快速康复。

方法

120 例食管癌患者在术前被随机分为呼吸功能锻炼组和常规护理组，每组60 例。呼吸功能锻炼组使用呼吸训练器锻炼，并训练腹式呼吸和有效咳嗽，每天高强度训练3 次，持续1 周。常规护理组行日间护理，而不行呼吸功能锻炼。监测两组患者手术前后气道中pH 值、呼吸指数、氧合指数和肿瘤坏死因子α（TNF-α）水平；术后肺部感染发生率采用简化后的肺部感染评分表进行测量。

结果

呼吸功能锻炼组术后气道中的pH 值、氧合指数均高于常规护理组，呼吸指数和TNF-α 水平均低于常规护理组，差异有统计学意义（P＜0.05）；呼吸功能锻炼组患者术后肺部感染发生率显著低于常规护理组（30.% vs 43.3% ），差异也有统计学意义（P＝0.017）。

结论

术前呼吸功能锻炼可有效降低术后肺部感染的发生。

Objective

The aim of this study is to evaluate whether preoperative respiratory function exercise can reduce the incidence of postoperative pulmonary infection in esophageal cancer and Promote rapid recovery of patients .

Methods

Patients with esophageal cancer were randomly assigned to the respiratory function exercise group and the routine care before surgery ,with 60 in each group .The respiratory exercise group exercised with a breathing exerciser and trained abdominal breathing and effective cough 3 times every day for one week . Routine care group performed normal daytime care without respiratory function exercise . The following data in both groups were collected and compared including patients pH value in airway before and after surgery ,respiration index ,oxygenation index ,and TNF-α . The incidences of pulmonary infection were also measured by the simplified pulmonary infection rating scale .

Results

In the respiratory exercise group ,patients postoperative airway pH and oxygenation index were higher than that of routine care group , while the respiration index and TNF-α were lower( P＜0 .05) .Of the 60 patients in the preoperative respiratory function exercise group , 18 had postoperative pulmonary infection , and 26 of the 60 patients in the routine care group had pulmonary infection .There was a statistically significant difference in postoperative outcome between the two group( P＜0 .05) .

Conclusions

Preoperative respiratory function exercise can effectively reduce the incidence of postoperative pulmonary infection .