Su Xue-E, Hong Wan-Ping, He He-Fan, Xie Baoyuan, Wu Shan-Hu
Department of Anaesthesia, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou , Fujian, 362000, China.
Department of Nursing, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou , Fujian, 362000, China.
Support Care Cancer. 2025 Jun 18;33(7):593. doi: 10.1007/s00520-025-09658-5.
Non-small cell lung cancer (NSCLC) patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy often face postoperative complications and delayed recovery. While preoperative smoking cessation and respiratory training are known to improve outcomes, the potential benefits of integrating traditional Chinese medicine (TCM) interventions, such as LIUZIJUE, remain underexplored.
This study aimed to evaluate the effects of preoperative respiratory training on perioperative outcomes in NSCLC patients undergoing VATS lobectomy, with a focus on peak expiratory flow (PEF), respiratory distress score (RPE), blood gas parameters, quality of recovery-15 (QOR-15), recovery room time, inflammatory markers (NLR, PLR), and postoperative complications.
A single-center randomized controlled trial was conducted at Fujian Medical University Affiliated Second Hospital from April 2023 to June 2024. Smokers requiring a 2-week cessation period before surgery were randomized into three groups: Control Group (CG, standard care), Intervention Group 1 (IG1, standard care plus device-based respiratory training), and Intervention Group 2 (IG2, standard care plus respiratory training and LIUZIJUE practice).
The combined intervention group (IG2) demonstrated significant improvements in multiple postoperative outcomes, including PEF, QOR-15, RPE, and SpO, outperforming both IG1 and CG. Subgroup analyses revealed that patients over 60 years old experienced more pronounced improvements in PEF, RPE, SpO, and QOR-15 scores. Additionally, patients with comorbidities showed notable improvements in SpO and RPE, while those without comorbidities exhibited greater gains in SpO, PEF, and QOR-15.
Preoperative respiratory training combined with LIUZIJUE significantly enhances postoperative recovery in NSCLC patients, with particularly marked benefits for older patients and those without comorbidities. These findings highlight the clinical potential of this intervention for broader application in perioperative care.
接受电视辅助胸腔镜手术（VATS）肺叶切除术的非小细胞肺癌（NSCLC）患者常面临术后并发症和恢复延迟的问题。虽然术前戒烟和呼吸训练已知可改善预后，但将中医干预措施，如六字诀，整合进来的潜在益处仍未得到充分探索。
本研究旨在评估术前呼吸训练对接受VATS肺叶切除术的NSCLC患者围手术期结局的影响，重点关注呼气峰值流速（PEF）、呼吸窘迫评分（RPE）、血气参数、恢复质量-15（QOR-15）、恢复室时间、炎症标志物（NLR、PLR）和术后并发症。
2023年4月至2024年6月在福建医科大学附属第二医院进行了一项单中心随机对照试验。术前需要2周戒烟期的吸烟者被随机分为三组：对照组（CG，标准护理）、干预组1（IG1，标准护理加基于设备的呼吸训练）和干预组2（IG2，标准护理加呼吸训练和六字诀练习）。
联合干预组（IG2）在多个术后结局方面表现出显著改善，包括PEF、QOR-15、RPE和SpO，优于IG1和CG。亚组分析显示，60岁以上患者在PEF、RPE、SpO和QOR-15评分方面的改善更为明显。此外，合并症患者的SpO和RPE有显著改善，而无合并症患者在SpO、PEF和QOR-15方面的改善更大。
术前呼吸训练联合六字诀可显著提高NSCLC患者的术后恢复，对老年患者和无合并症患者的益处尤为显著。这些发现突出了这种干预措施在围手术期护理中更广泛应用的临床潜力。
