HOME REHABILITATION FOR PREOPERATIVE THORACOTOMY PATIENTS

我们研究家庭康复是否能改善术前开胸患者的肺功能和运动能力。本研究纳入14例术前肺癌患者（68(]SY.+-[)5yr）。用里程表测量一周的一天步行步数（WS），并计算WS的平均值。这些患者被鼓励在家散步两次或两次以上。康复前后分别进行肺功能检查和3分钟。进行增量运动试验。8例maxVO<@D22@>D2或血乳酸阈值改善5%或以上的患者被归类为有效组(E)， 6例没有改善的患者被归类为无效组（NON）。康复时间短、WS增加不足、肺癌进展及相关心脏病被认为是家庭康复失败的原因。E组为恢复期WS。是康复前WS的2.5(]SY.+-[)1.8倍。康复时间29(]SY。+ - - - - - -(7天)。FVC (3.04 (SY。+ -)1.00 - > 3.25 (SY。+ -)0.93 l, p = 0.02)和VC (3.13 (SY。+ -)0.97 - > 3.35 (SY。+ - (l) 0.99, p = 0.0018)康复后显著增加。但FEV1.0 (1.90 (SY。+ -)0.70 - > 1.94 (SY。+ -)0.68 l / s)和MVV (73.1 (SY。+ -)26.3 - > 75.2 (SY。+ - ()27.7 l / min)没有。MaxVO < @D22@ > D2 / BSA (623 (SY。+ -)181 - > 705 (SY。+ - 168 ml / min()。/ m < @D12@ > D1;p = 0.0003), maxO < @D22@ > D2脉冲(4.64 (SY。+ -)1.23 - > 5.17 (SY。+ -)1.13 ml /打/ m < @D12@ > D1;p=0.0011)，血乳酸阈值(452(]SY.+-[)88—504(]SY.+-[)108ml/min。/ m < @D12@ > D1;P =0.0052)显著增高。我们的结论是，使用里程表进行大约一个月的家庭康复可以提高术前开胸患者的运动能力。

We investigated whether home rehabilitation (rehab) can improve pulmonary function and exercise capacity in preoperative thoracotomy patients. Fourteen preoperative lung cancer patients (68(]SY.+-[)5yr) were included in this study. Number of one-day walking step (WS) was measured with an odometer for a week and a mean of the WS was calculated. The patients were encouraged to walk at home two times or more than the mean WS.Before and after the rehab a pulmonary function test and 3-min.incremental exercise test were administered. Eight patients who demonstrated 5% or more improvement in maxVO<@D22@>D2 or blood lactate threshold were categorized to an effective group (E) and 6 patients who did not were categorized to a non-effective group (NON). The short duration of rehab, insufficient increase in the WS,progress of lung cancer, and associated heart disease were thought to be causes of failure of the home hehabilitation. In the E group, the WS during rehab.was 2.5(]SY.+-[)1.8 times of the pre-rehab WS.The duration of rehab was 29(]SY.+-[)7 days. FVC (3.04(]SY.+-[)1.00-->3.25(]SY.+-[)0.93L,p=0.02) and VC (3.13(]SY.+-[)0.97-->3.35(]SY.+-[)0.99L,p=0.0018) increased significantly after rehab. but FEV1.0 (1.90(]SY.+-[)0.70-->1.94(]SY.+-[)0.68L/s) and MVV (73.1(]SY.+-[)26.3-->75.2(]SY.+-[)27.7L/min) did not. MaxVO<@D22@>D2/BSA (623(]SY.+-[)181-->705(]SY.+-[)168ml/min./m<@D12@>D1 ; p=0.0003), maxO<@D22@>D2 pulse (4.64(]SY.+-[)1.23-->5.17(]SY.+-[)1.13ml/beat/m<@D12@>D1 ; p=0.0011) and blood lactate threshold (452(]SY.+-[)88-->504(]SY.+-[)108ml/min./m<@D12@>D1 ; p=0.0052) significantly increased after the rehab. We conclude that home rehabilitation for about a month using an odometer may improve exercise capacity in preoperative thoracotomy patients.