Esteban Pedro A, Hernández Nieves, Novoa Nuria M, Varela Gonzalo
Department of Surgery, General Thoracic Surgery Service, Salamanca University Hospital, Salamanca, Spain.
Interact Cardiovasc Thorac Surg. 2017 Aug 1;25(2):268-271. doi: 10.1093/icvts/ivx100.
The goal of this study was to describe non-supervised daily physical activity in patients during the period immediately following anatomical lung resection.
The study was an observational study on 50 consecutive patients (33 men) admitted for anatomical lung resection over a 4-month period. All cases were approached using a minimally invasive technique. Patients were instructed by nursing and physiotherapy staff and asked to wear a portable pedometer (Omron HJ-720 T-E2) from admission until hospital discharge, excluding the day of the operation and the first hours in the recovery room. The variables collected included sex, age, body mass index, type of lung resection, cardiopulmonary postoperative complications, percentage forced expiratory volume in 1 s, percentage single-breath carbon monoxide diffusing capacity, predicted postoperative forced expiratory volume in 1 s calculated according to functional segments removed at surgery, predicted postoperative single-breath carbon monoxide diffusing capacity calculated according to functional segments removed at surgery, total steps, aerobic steps and daily total strolled distance in metres. Comparison of activity was analysed using the paired t-test for individual data evolution and the unpaired t-test for patients showing complications or not. Body mass index and exercise capacity were analysed using the Spearman correlation analysis.
A total of 34 patients underwent lobectomy or bilobectomy. All patients could walk on the first postoperative day. The average walked distance on the first and fourth postoperative days was 6100 m and 7400 m, respectively. Compared with the preoperative day, patients walked significantly fewer total steps on Day 1 and Day 2 (Day 1, P = 0.0001; Day 2, P = 0.049). The rate of aerobic to total daily steps was comparable after the second postoperative day. Patients having any postoperative cardiopulmonary complication showed a significantly inferior walking capacity (P < 0.001), both preoperatively and postoperatively, than their peers without complications.
After anatomical lung resection, patients could perform a relevant amount of physical activity. These data could be useful for designing physical recovery programmes to be implemented postoperatively.
本研究的目的是描述解剖性肺切除术后患者即刻的非监督日常身体活动情况。
本研究是一项观察性研究，对连续50例患者（33例男性）进行了为期4个月的解剖性肺切除手术。所有病例均采用微创技术。患者由护理和物理治疗人员指导，并要求从入院到出院佩戴便携式计步器（欧姆龙HJ-720 T-E2），手术当天和恢复室的头几个小时除外。收集的变量包括性别、年龄、体重指数、肺切除类型、心肺术后并发症、第1秒用力呼气量百分比、单次呼吸一氧化碳弥散量百分比、根据手术切除的功能段计算的术后预计第1秒用力呼气量、根据手术切除的功能段计算的术后预计单次呼吸一氧化碳弥散量、总步数、有氧运动步数和每日总步行距离（米）。使用配对t检验分析个体数据变化的活动情况，使用非配对t检验分析有无并发症患者的活动情况。使用Spearman相关分析分析体重指数和运动能力。
共有34例患者接受了肺叶切除术或双肺叶切除术。所有患者术后第一天即可行走。术后第一天和第四天的平均步行距离分别为6100米和7400米。与术前相比，患者在术后第1天和第2天的总步数明显减少（第1天，P = 0.0001；第2天，P = 0.049）。术后第二天后，每日有氧运动步数与总步数的比例相当。有任何术后心肺并发症的患者，术前和术后的行走能力均明显低于无并发症的同龄人（P < 0.001）。
解剖性肺切除术后，患者可以进行相当量的身体活动。这些数据可能有助于设计术后实施的身体恢复计划。
