Çınar Hüseyin Ulaş, Kefeli Çelik Hale, Çelik Burçin, Doğan Cengizhan
Department of Thoracic Surgery, Medicana International Hospital, Samsun, Turkey.
Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Oct 21;28(4):638-647. doi: 10.5606/tgkdc.dergisi.2020.19693. eCollection 2020 Oct.
The aim of this study was to investigate the effects of a postoperative respiratory physiotherapy program on pulmonary complications, length of hospital stay, and hospital cost after lobectomy for lung cancer.
A total of 90 patients (75 males, 15 females; mean age 63.1±10.4 years; range, 30 to 82 years) who underwent elective lobectomy through thoracotomy due to lung cancer between June 2014 and December 2019 were retrospectively analyzed. The patients were divided into two groups as Group S who received standard postoperative care (n=50) and Group P who received postoperative respiratory physiotherapy in addition to standard care (n=40). Both groups were compared in terms of postoperative pulmonary complications, 30-day mortality, length of hospital stay, and hospital cost.
The preoperative and surgical characteristics of the groups were similar. Group P had a lower incidence of postoperative pulmonary complications (10% vs. 38%, respectively; p=0.002) than Group S. The median length of stay in the hospital was six (range, 4 to 12) days in Group P and seven (range, 4 to 40) days in Group S (p=0.001). The drug cost (639.70 vs. 1,211.46 Turkish Liras, respectively; p=0.001) and the total hospital cost (2,031.10 vs. 3,778.68 Turkish Liras, respectively; p=0.001) of the patients in Group P were significantly lower. The multivariate logistic regression analysis showed that respiratory physiotherapy had a protective effect on the development of postoperative pulmonary complications (odds ratio =0.063, 95% confidence interval: 0.010-0.401, p=0.003).
An intensive physiotherapy program focusing on respiratory exercises is a cost-effective practice which reduces the risk of development of postoperative pulmonary complications in patients undergoing lobectomy for lung cancer.
本研究旨在探讨术后呼吸物理治疗方案对肺癌肺叶切除术后肺部并发症、住院时间和住院费用的影响。
回顾性分析2014年6月至2019年12月期间因肺癌接受择期开胸肺叶切除术的90例患者（75例男性，15例女性；平均年龄63.1±10.4岁；范围30至82岁）。患者分为两组，S组接受标准术后护理（n = 50），P组在标准护理基础上接受术后呼吸物理治疗（n = 40）。比较两组术后肺部并发症、30天死亡率、住院时间和住院费用。
两组患者术前及手术特征相似。P组术后肺部并发症发生率低于S组（分别为10%和38%；p = 0.002）。P组患者的中位住院时间为6天（范围4至12天），S组为7天（范围4至40天）（p = 0.001）。P组患者的药物费用（分别为639.70和1211.46土耳其里拉；p = 0.001）和总住院费用（分别为2031.10和3778.68土耳其里拉；p = 0.001）显著更低。多因素逻辑回归分析显示，呼吸物理治疗对术后肺部并发症的发生具有保护作用（比值比 = 0.063，95%置信区间：0.010 - 0.401，p = 0.003）。
以呼吸锻炼为重点的强化物理治疗方案是一种具有成本效益的做法，可降低肺癌肺叶切除患者术后肺部并发症的发生风险。
