Breathing training method for rapid recovery of lung function after general thoracic surgery

Abstract

The invention provides a respiratory training method for rapid recovery of lung functions after general thoracic surgery, and belongs to the technical field of medical rehabilitation, the respiratory training method for rapid recovery of lung functions after general thoracic surgery comprises the following steps: performing preoperative evaluation, measuring parameters such as vital capacity, making a personalized training plan in combination with age, basic diseases and operation types, and establishing a personalized training plan for rapid recovery of lung functions after general thoracic surgery; the method is divided into an early stage, a middle stage and a later stage, and abdominal respiration and lip contraction respiration training is carried out in the early stage; in the middle stage, deep respiration and excitation type spirometer training are increased; resistance breathing and breathing exercise training is conducted in the later stage, parameters such as breathing frequency and subjective feeling of patients are closely monitored in the training, the training intensity and method are adjusted according to conditions, accurate training can be conducted according to individual differences of the patients, the lung function rehabilitation efficiency is effectively improved, complications are reduced, and the life quality of the patients is improved. The device is suitable for general thoracic surgery postoperative patients.

Description

Technical Field

[0001] The invention belongs to the technical field of medical rehabilitation, and in particular relates to a breathing training method for rapid recovery of lung function after general thoracic surgery. Background Art

[0002] General thoracic surgery, such as lung resection and esophageal surgery, is often accompanied by impaired lung function after surgery, which has a significant impact on the patient's recovery process and quality of life. Currently, the recovery of lung function after general thoracic surgery in clinical practice mostly relies on conventional breathing training methods, but these methods have many shortcomings. Traditional breathing training often lacks personalized customization and does not fully consider the differences in patients' preoperative lung function (such as different indicators such as vital capacity, forced vital capacity, forced expiratory volume in the first second, and maximum ventilation), age factors, the presence of underlying diseases such as chronic obstructive pulmonary disease or cardiovascular disease, and the different degrees of influence of surgical types (wedge resection of the lung, lobectomy, pneumonectomy, esophageal surgery, etc.) on lung function. This results in the inability of the training plan to accurately adapt to the individual needs of patients, which may cause some patients to have insufficient training intensity and slow recovery of lung function, while some patients will experience fatigue or other adverse reactions due to excessive training, increasing the risk of lung complications.

[0003] To solve the above problems, the present invention proposes a breathing training method for rapid recovery of lung function after general thoracic surgery. The method uses a comprehensive preoperative evaluation, including accurate measurement of multiple lung function parameters and detailed chest imaging examinations, to gain an in-depth understanding of the initial state of the patient's lungs. A personalized training plan is formulated based on the evaluation results. The plan is implemented in three stages: early, middle and late. In the early stage, gentle abdominal breathing and pursed lip breathing training are adopted. In the middle stage, deep breathing and incentive spirometer training are added. In the late stage, resistance breathing and breathing exercises training are performed. In the whole process, the patient's breathing-related parameters and subjective feelings are closely monitored, and the training intensity and methods are dynamically adjusted. In this way, it is expected to effectively improve the efficiency of lung function recovery in patients after general thoracic surgery, reduce lung complications, and improve the quality of life of patients. Summary of the invention

[0004] The purpose of the present invention is to provide a breathing training method for rapid recovery of lung function after general thoracic surgery, aiming to solve the problem that traditional methods in the prior art do not fully consider the differences in various indicators of patients' preoperative lung function, the different degrees of influence of age, underlying diseases and surgical types on lung function, resulting in a mismatch between the training plan and the individual needs of patients, and are prone to improper training intensity, affecting the recovery of lung function, and even causing adverse reactions and increasing the risk of lung complications.

[0005] To achieve the above object, the present invention provides the following technical solutions:

[0006] A breathing training method for rapid recovery of lung function after general thoracic surgery, characterized in that it comprises the following steps:

[0007] S1. Preoperative evaluation:

[0008] Measure the patient's vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximum ventilation volume (MVV) parameters, and comprehensively evaluate the initial state of the patient's lung function in combination with the patient's age, the presence of underlying diseases, and the type of surgery; the underlying diseases include chronic obstructive pulmonary disease and cardiovascular disease; the types of surgery include lung wedge resection, lobectomy, pneumonectomy, and esophageal surgery;

[0009] S2. Observe the lung anatomy through chest X-ray and CT scan to check the lung texture, the presence of bullae, emphysema and the condition of lung tissue around the surgical area;

[0010] Training plan formulation: According to the preoperative evaluation results, a personalized breathing training plan is formulated for the patient, and the training plan is divided into three stages: early, middle and late. Among them, if the patient has good preoperative lung function, is young and the surgical trauma is small, the training plan will be relatively radical; if the patient has poor preoperative lung function, is old and weak or the surgical scope is large, the training will start with a moderate intensity and gradually increase the intensity;

[0011] S3. Phased breathing training:

[0012] Early training (1-3 days after surgery):

[0013] Abdominal breathing training: The patient lies on his back, relaxes the whole body, puts one hand on the chest and the other hand on the abdomen, inhales slowly through the nose to make the abdomen bulge, and the hand on the abdomen rises accordingly, and the hand on the chest keeps still as much as possible, and then exhales slowly through the mouth to make the abdomen contract and sink. Each training lasts 10-15 minutes, 3-4 times a day;

[0014] Pursed lip breathing training: The patient closes his mouth and inhales through the nose, then purses his lips and exhales slowly in a whistle-like manner. The exhalation time is 2-3 times the inhalation time. Each training lasts 10-15 minutes, 3-4 times a day.

[0015] Mid-term training (4-7 days after surgery):

[0016] Deep breathing training: The patient is in a comfortable position, takes a slow, deep breath to fully expand the chest, and then exhales slowly. The ratio of inhalation to exhalation time is about 1:2. Each training session lasts 15-20 minutes, and the training is done 3-4 times a day.

[0017] Incentive spirometer training: The patient holds the incentive spirometer, holds the mouthpiece after normal exhalation, and slowly and deeply inhales to make the piston in the spirometer reach the preset target value, and maintains it for a period of time, 5-6 sets a day, 10-12 times each set;

[0018] Late training (8 days after surgery - before discharge):

[0019] Resistance breathing training: patients use a breathing trainer with adjustable resistance to overcome the set resistance when inhaling. Each training session lasts 20-30 minutes, and the training is performed 2-3 times a day.

[0020] Breathing exercise training: The patient stands, clenches his fists, stretches his arms forward, expands his chest to both sides and takes a deep breath, then bends over and touches his feet with both hands while exhaling, and inhales when standing up. Each breathing exercise lasts 20-30 minutes, 2-3 times a day;

[0021] Training supervision and adjustment steps: During the training process, medical staff monitor the patient's respiratory rate, depth, and blood oxygen saturation parameters, and ask the patient about his or her subjective feelings; if the patient experiences shortness of breath or a sharp drop in blood oxygen saturation, the training will be suspended, and after the patient's condition stabilizes, the training intensity will be reduced or the training method will be modified.

[0022] As a preferred solution of the present invention, in the abdominal breathing training, the amplitude of the abdominal bulge is adjusted according to the patient's tolerance to ensure the effectiveness and safety of the breathing training.

[0023] As a preferred solution of the present invention, in the pursed lip breathing training, the ratio of exhalation time to inhalation time is adjusted according to the patient's tolerance and breathing conditions, but the exhalation time is always maintained at 2-3 times the inhalation time.

[0024] As a preferred solution of the present invention, in the incentive spirometer training, the preset target value is adjusted according to the patient's preoperative lung function assessment results and the current training stage.

[0025] As a preferred solution of the present invention, in the resistance breathing training, the resistance is adjusted according to the patient's training progress and respiratory muscle strength, and the resistance range is within a range that allows the patient to complete the training movements without causing excessive fatigue and abnormal respiratory function.

[0026] As a preferred solution of the present invention, in the breathing exercise training, the range of motion of chest expansion and waist bending is appropriately adjusted according to the patient's body flexibility and comfort;

[0027] The phase division of the early training, mid-term training and late training can be appropriately fine-tuned according to the actual recovery condition of the patient, and the fine-tuning range is within 1-2 days.

[0028] Compared with the prior art, the present invention has the following beneficial effects:

[0029] 1. In this program, by accurately measuring multiple lung function parameters, combining age and underlying disease assessment, and considering the impact of the type of surgery, a highly personalized training plan can be developed for patients. For patients with good preoperative lung function, young age, and less surgical trauma, a relatively aggressive training plan is given, such as increasing the frequency and duration of training, so as to give full play to their recovery potential; while for patients with poor preoperative lung function, the elderly and frail, or patients with a large surgical range, start with a moderate intensity and gradually increase the intensity to avoid overtraining, ensure that the training is safe and effective, and thus improve the efficiency of lung function rehabilitation;

[0030] The training is divided into three stages: early, middle and late. Each stage has clear goals and targeted training methods. The early abdominal breathing and pursed lip breathing training are simple and gentle, which help to restore the basic ventilation function of the lungs in the fragile period after surgery and prevent complications; in the middle stage, deep breathing and incentive spirometer training are added to improve ventilation and gas exchange capabilities; in the late stage, resistance breathing and breathing exercises training consolidate and optimize lung function, so that lung function gradually approaches or reaches the preoperative level, and improves patients' quality of life and breathing ability.

[0031] 2. In this plan, during the training process, medical staff closely monitor the patient's respiratory rate, depth, blood oxygen saturation and other parameters, and can promptly detect abnormal lung function or over-training. Abnormalities such as breathing rate that is too fast or too slow, and a sharp drop in blood oxygen saturation can be quickly captured to avoid severe hypoxia or other complications caused by training, and ensure the safety of patient training.

[0032] 3. In this program, medical staff ask patients about their subjective feelings and adjust the training intensity or method based on the monitoring data according to the actual situation of the patient. If the patient feels uncomfortable during training, such as feeling strenuous or having abnormal respiratory function during resistance breathing training, the resistance of the trainer can be reduced or the training movements can be adjusted; if the patient completes the training easily and is in good condition, the training difficulty can be appropriately increased. This dynamic adjustment ensures that the training always adapts to the individual condition of the patient, promotes the continuous recovery of lung function, and improves the patient's compliance with training. DETAILED DESCRIPTION

[0033] The following will be combined with the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0034] Example 1

[0035] The present invention provides the following technical solutions:

[0036] A breathing training method for rapid recovery of lung function after general thoracic surgery, characterized in that it comprises the following steps:

[0037] S1. Preoperative evaluation:

[0038] Measure the patient's vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximum ventilation volume (MVV) parameters, and comprehensively evaluate the initial state of the patient's lung function in combination with the patient's age, the presence of underlying diseases, and the type of surgery; the underlying diseases include chronic obstructive pulmonary disease and cardiovascular disease; the types of surgery include lung wedge resection, lobectomy, pneumonectomy, and esophageal surgery;

[0039] S2. Observe the lung anatomy through chest X-ray and CT scan to check the lung texture, the presence of bullae, emphysema and the condition of lung tissue around the surgical area;

[0040] Training plan formulation: According to the preoperative evaluation results, a personalized breathing training plan is formulated for the patient, and the training plan is divided into three stages: early, middle and late. Among them, if the patient has good preoperative lung function, is young and the surgical trauma is small, the training plan will be relatively radical; if the patient has poor preoperative lung function, is old and weak or the surgical scope is large, the training will start with a moderate intensity and gradually increase the intensity;

[0041] S3. Phased breathing training:

[0042] Early training (1-3 days after surgery):

[0043] Abdominal breathing training: The patient lies on his back, relaxes the whole body, puts one hand on the chest and the other hand on the abdomen, inhales slowly through the nose to make the abdomen bulge, and the hand on the abdomen rises accordingly, and the hand on the chest keeps still as much as possible, and then exhales slowly through the mouth to make the abdomen contract and sink. Each training lasts 10-15 minutes, 3-4 times a day;

[0044] Pursed lip breathing training: The patient closes his mouth and inhales through the nose, then purses his lips and exhales slowly in a whistle-like manner. The exhalation time is 2-3 times the inhalation time. Each training lasts 10-15 minutes, 3-4 times a day.

[0045] Mid-term training (4-7 days after surgery):

[0046] Deep breathing training: The patient is in a comfortable position, takes a slow, deep breath to fully expand the chest, and then exhales slowly. The ratio of inhalation to exhalation time is about 1:2. Each training session lasts 15-20 minutes, and the training is done 3-4 times a day.

[0047] Incentive spirometer training: The patient holds the incentive spirometer, holds the mouthpiece after normal exhalation, and slowly and deeply inhales to make the piston in the spirometer reach the preset target value, and maintains it for a period of time, 5-6 sets a day, 10-12 times each set;

[0048] Late training (8 days after surgery - before discharge):

[0049] Resistance breathing training: patients use a breathing trainer with adjustable resistance to overcome the set resistance when inhaling. Each training session lasts 20-30 minutes, and the training is performed 2-3 times a day.

[0050] Breathing exercise training: The patient stands, clenches his fists, stretches his arms forward, expands his chest to both sides and takes a deep breath, then bends over and touches his feet with both hands while exhaling, and inhales when standing up. Each breathing exercise lasts 20-30 minutes, 2-3 times a day;

[0051] Training supervision and adjustment steps: During the training process, medical staff monitor the patient's respiratory rate, depth, and blood oxygen saturation parameters, and ask the patient about his or her subjective feelings; if the patient experiences shortness of breath or a sharp drop in blood oxygen saturation, the training will be suspended, and after the patient's condition stabilizes, the training intensity will be reduced or the training method will be modified.

[0052] In a specific embodiment of the present invention, S1. Preoperative evaluation: Importance and interpretation of lung function parameter measurement: Vital capacity (VC) is the maximum ventilation volume in one breath, which can reflect the maximum ventilation capacity of the lungs. Forced vital capacity (FVC) focuses more on evaluating the emptying capacity of the lungs under forced exhalation. Its value is significantly different from that of VC in certain airway obstructive diseases. The forced expiratory volume in the first second (FEV1) is of key significance in assessing the degree of airway obstruction. For example, in chronic obstructive pulmonary disease, the FEV1 / FVC ratio is often significantly reduced. Maximum ventilation volume (MVV) can reflect the reserve function of lung ventilation. The comprehensive measurement of these parameters provides a quantitative basis for a comprehensive understanding of the patient's lung function. At the same time, combined with age factors, because with age, the elasticity of the lungs will gradually decrease, and the lung function will also decline accordingly. For patients with underlying diseases such as chronic obstructive pulmonary disease and cardiovascular disease, their lung function may have been impaired, and the impact of surgery on lung function may be more significant. Different types of surgeries cause different degrees of trauma to the lungs. Wedge resection of the lung has relatively little effect on lung function, while pneumonectomy has a great impact on lung function. Esophageal surgery may also indirectly affect lung function because the surgical operation involves areas near the chest cavity.

[0053] Details and significance of imaging examinations: Chest X-rays can provide general information such as the overall outline and density of the lungs, and can preliminarily observe whether there are obvious consolidations, effusions or large structural abnormalities in the lungs. CT scans are more detailed and can clearly show the texture of the lungs. Normal lung texture is distributed in a dendritic manner with uniform thickness. If the texture is thickened or disordered, it may indicate inflammation or other lesions in the lungs. Bullae appear on CT images as localized air-containing sacs with thin walls, which can be single or multiple, and have a certain impact on the ventilation function of the lungs. Emphysema is manifested as increased lung translucency and sparse lung texture, which means that the alveolar wall is destroyed and the lung elasticity is reduced. Observing the condition of the lung tissue around the surgical area is also crucial for predicting the recovery of lung function after surgery, such as whether there is inflammation or adhesion around the surgical area. This information will help to formulate a more accurate respiratory training plan.

[0054] Training plan formulation: Basis and adjustment principles of personalized plans: According to the information such as the initial state of lung function, patient physical condition and type of surgery obtained from preoperative evaluation, the formulation of personalized training plans is the key to ensure the training effect and patient safety. For patients with good preoperative lung function, young age and less surgical trauma, their physical recovery ability is stronger, so the training plan can be relatively radical, such as appropriately increasing the frequency of training and the duration of each training session in the early training stage. For patients with poor preoperative lung function, old and weak or large surgical range, due to their low lung function reserve and weak recovery ability, they need to start with a mild training intensity, such as reducing the time of each training session, reducing the difficulty of the movements, etc., and gradually increase the training intensity as the patient's lung function gradually recovers. This gradual adjustment of the training plan can effectively prevent patients from experiencing adverse reactions due to excessive training, while also ensuring continuous improvement of lung function.

[0055] Principle of training phase division: The training plan is divided into three phases: early, middle and late, and each phase has its specific goals and training methods. The early phase is mainly during the period when the body is relatively fragile after surgery. Relatively simple and gentle breathing training methods, such as abdominal breathing and pursed lip breathing, are used to promote the recovery of basic ventilation function of the lungs and prevent lung complications, such as atelectasis and lung infection. In the middle phase, as the patient's body gradually recovers, deep breathing training and incentive spirometer training are added, with the focus on improving the ventilation and gas exchange capacity of the lungs and further improving lung function. The late phase is to consolidate and optimize lung function. Through comprehensive training methods such as resistance breathing training and breathing exercises, the lung function is close to or reaches the preoperative level, improving the patient's quality of life and breathing ability.

[0056] S3. Phased breathing training:

[0057] Early training: The physiological mechanism of abdominal breathing training: Abdominal breathing mainly relies on the movement of the diaphragm. When the patient inhales through the nose, the diaphragm contracts and descends, causing the abdominal organs to move downward, resulting in a bulging abdomen. This method can increase the range of motion of the diaphragm and promote ventilation of the lower lobe of the lungs. When exhaling, the diaphragm relaxes and rises, and the abdomen contracts and sinks. Compared with chest breathing, this breathing method can more effectively utilize the capacity of the lungs, especially for patients with impaired lung function after surgery. It helps to reactivate and enhance diaphragm function and improve lung ventilation efficiency. Moreover, by placing one hand on the chest and the other on the abdomen, patients can better feel the movement of the diaphragm and thorax during breathing, which is convenient for self-adjustment of breathing methods and improves training effects.

[0058] The principle and benefits of pursed lip breathing training: Pursed lip breathing training is a method to improve lung ventilation by increasing expiratory resistance. After the patient closes his mouth and inhales through the nose, he purses his lips and exhales slowly in a whistle-like manner, extending the exhalation time to 2-3 times the inhalation time. This method can increase the pressure in the airway during exhalation and prevent the premature collapse of the small airways, especially for those patients whose small airway function is impaired due to surgery or lung disease. By keeping the airway open, it is beneficial for the gas in the alveoli to be fully discharged, reducing gas retention, and improving the ventilation and gas exchange function of the lungs. At the same time, this training method can also regulate the breathing rate, make breathing more regular and deep, and relieve the symptoms of dyspnea.

[0059] Mid-term training: The mechanism of deep breathing training: Deep breathing training requires the patient to be in a comfortable position, take a slow and deep breath to fully expand the chest, and then exhale slowly. During deep inhalation, the expansion of the chest can drive the expansion of the lungs, allowing more air to enter the lungs, including every corner of the alveoli, thereby increasing vital capacity and pulmonary ventilation. This training method can activate and strengthen the strength of the respiratory muscles, especially the intercostal muscles and diaphragm. At the same time, by adjusting the time ratio of inhalation and exhalation to about 1:2, the lungs can have enough time for gas exchange, improve ventilation efficiency, promote oxygen intake and carbon dioxide discharge, and further improve lung function.

[0060] Advantages and key points of motivational spirometer training: Motivational spirometer training uses a handheld device for inhalation. After normal exhalation, the patient holds the mouthpiece and inhales slowly and deeply, so that the piston in the spirometer reaches the preset target value and maintains it for a period of time. This training method can provide visual feedback to patients, motivating them to inhale hard and increase their inspiratory strength. The preset target value is adjusted according to the patient's preoperative lung function assessment results and the current training stage to ensure that the training is challenging but within the patient's tolerance. 5-6 sets of 10-12 training sessions per day can effectively improve the patient's inspiratory capacity and respiratory muscle strength, and promote lung expansion and ventilation function recovery.

[0061] Later training: The targetedness and effect of resistance breathing training: Resistance breathing training uses a breathing trainer with adjustable resistance, and the patient needs to overcome the set resistance when inhaling. This resistance training can specifically enhance the strength of the inspiratory muscles, including the diaphragm and external intercostal muscles. As the training continues, the respiratory muscles will gradually adapt and overcome greater resistance, becoming stronger. Stronger respiratory muscle strength can allow the lungs to expand more fully during inhalation, improving lung capacity and ventilation function. Each training session lasts 20-30 minutes, and the training frequency and duration of 2-3 training sessions per day ensures the intensity of the training while avoiding the effects of excessive fatigue on the patient's body.

[0062] Comprehensive benefits of breathing exercise training: Breathing exercise training is a comprehensive training method, including combined movements such as chest expansion exercise, bending exercise and deep breathing exercise. In the chest expansion exercise, the patient stands, clenches his fists, stretches his arms forward and then expands his chest to both sides, while taking deep breaths. This movement can expand the range of motion of the thorax, stretch related muscles such as the intercostal muscles and pectoralis major, increase the volume of the chest cavity, and facilitate the expansion of the lungs. In the bending exercise, the patient bends over and touches his feet with both hands as much as possible while exhaling and inhaling when standing up. This movement can promote the compression and relaxation of the diaphragm by the abdominal organs, enhance the range of motion of the diaphragm, and also exercise the strength of the waist and abdominal muscles to assist respiratory function. The entire breathing exercise training, through the synergistic effect of multiple movements, comprehensively exercises the motor ability of the respiratory muscles and the thorax, further improves lung function, and enables patients to resume normal breathing patterns and living abilities more quickly after surgery.

[0063] Training supervision and adjustment steps: The significance and judgment criteria of monitoring parameters: During the training process, it is crucial for medical staff to monitor the patient's respiratory rate, depth, blood oxygen saturation and other parameters. Changes in respiratory rate can reflect the state of the patient's respiratory function. Too fast or too slow respiratory rate may indicate abnormal lung function or overtraining. The depth of breathing is directly related to the ventilation volume of the lungs. Too shallow breathing may lead to insufficient ventilation. Blood oxygen saturation is an important indicator reflecting the oxygen content in the blood and should be maintained at a high level under normal circumstances. Generally speaking, if the blood oxygen saturation drops sharply, it may mean that there are serious problems with the ventilation function of the lungs, affecting the intake of oxygen. By asking the patient's subjective feelings, such as the degree of dyspnea and fatigue, medical staff can have a more comprehensive understanding of the patient's tolerance to training. If the patient has shortness of breath (the respiratory rate is significantly faster and exceeds the normal range by a large margin), a sharp drop in blood oxygen saturation (such as a drop of more than a certain proportion in a short period of time, such as 5% or more), etc., the training needs to be suspended to avoid more serious hypoxia or other complications in the patient.

[0064] Methods and precautions for adjusting training: When the patient's condition stabilizes, the intensity or method of training needs to be adjusted. Reducing the intensity of training can include reducing the training time, reducing the difficulty of movements, or reducing the number of training sessions. For example, if the patient feels uncomfortable during resistance breathing training, the resistance of the trainer can be appropriately reduced. Modifying the training method may involve changing the type of breathing training or adjusting the order of training. During the adjustment process, pay close attention to the patient's response to ensure that the adjusted training plan can continue to promote the recovery of lung function and will not cause adverse reactions in the patient again. At the same time, medical staff need to maintain good communication with patients so that patients understand the necessity and significance of training adjustments and improve patient compliance.

[0065] Specifically in this solution, during the abdominal breathing training, the amplitude of the abdominal bulge is adjusted according to the patient's tolerance to ensure the effectiveness and safety of the breathing training.

[0066] In this embodiment: For abdominal breathing training, the medical staff closely observes the patient's reaction when guiding the patient's training. At the beginning, the patient is trained with a relatively slight range of abdominal bulge, for example, only slightly bulging the abdomen. If the patient does not feel discomfort during the training process, such as no worsening of dyspnea, abdominal pain or other abnormal sensations, the amplitude of the abdominal bulge can be gradually increased. For example, in subsequent training, the patient is guided to try to make the abdomen bulge higher to achieve more adequate diaphragm movement. However, if the patient expresses discomfort, such as feeling breathless or excessive abdominal muscle tension, the medical staff will make timely adjustments to allow the patient to appropriately reduce the amplitude of the abdominal bulge to ensure that the breathing training can effectively stimulate the diaphragm movement and promote lung ventilation without causing damage to the patient's body, thereby ensuring the safety of the training.

[0067] Specifically in this solution, during the pursed lip breathing training, the ratio of exhalation time to inhalation time is adjusted according to the patient's tolerance and breathing conditions, but the exhalation time is always maintained at 2-3 times the inhalation time.

[0068] In this embodiment: when performing pursed lip breathing training, the medical staff will finely adjust the ratio of exhalation to inhalation time according to the patient's tolerance and breathing conditions. For patients who have just started training or have poor respiratory function and low tolerance, the exhalation time can be kept at 2 times the inhalation time. During the training process, the medical staff observes the patient's respiratory rate, depth, blood oxygen saturation and other indicators, and asks the patient's subjective feelings, such as whether he feels tired or has difficulty breathing. If the patient is in good condition, the exhalation time can be gradually increased to make the ratio of exhalation to inhalation time closer to 3 times. For example, when the patient's inhalation time is 3 seconds, it can start with 6 seconds of exhalation, and then adjust to 9 seconds of exhalation according to the situation. However, if the patient has shortness of breath or decreased blood oxygen saturation during the training process, the exhalation time will be appropriately shortened to maintain a ratio of about 2 times the inhalation time to ensure that the training is within the patient's tolerance range, and at the same time, the exhalation time is always kept in the interval of 2-3 times the inhalation time, so as to play the role of pursed lip breathing training in increasing airway pressure and preventing small airway collapse.

[0069] Specifically in this solution, in the incentive spirometer training, the preset target value is adjusted according to the patient's preoperative lung function assessment results and the current training stage.

[0070] In this embodiment: the preset target value of the incentive spirometer training is adjusted as follows. In the early stage of training, for patients with good preoperative lung function, the preset target value can be set to 60%-70% of their preoperative maximum inspiratory volume. For example, if the patient's preoperative maximum inspiratory volume is 3000ml, the initial target value can be set to 1800-2100ml. As the training stage progresses, the target value can be increased to 70%-80% of the preoperative maximum inspiratory volume in the middle stage, and further increased to 80%-90% in the later stage. For patients with poor preoperative lung function, the initial preset target value may be only 40%-50% of their preoperative maximum inspiratory volume, and then gradually increased in the middle and late stages according to the recovery during the training process. For example, if the patient's preoperative maximum inspiratory volume is 2000ml, the initial target value is set to 800-1000ml, which can be adjusted to 1000-1200ml in the middle stage, and can reach 1200-1600ml in the later stage. At the same time, at each training stage, if the patient feels very strenuous or has abnormal breathing when reaching the preset target value, the medical staff will appropriately lower the target value; if the patient easily reaches the target value and is in good condition, the target value can be appropriately increased to ensure the effectiveness and adaptability of the training.

[0071] Specifically in this solution, during the resistance breathing training, the resistance is adjusted according to the patient's training progress and respiratory muscle strength, and the resistance range is within a range that allows the patient to complete the training movements without causing excessive fatigue and abnormal respiratory function.

[0072] In this embodiment: For resistance breathing training, a lower resistance will be set for the patient at the beginning. The medical staff will first evaluate the patient's respiratory muscle strength, for example, asking the patient to perform a simple inhalation movement to feel the strength of the muscle. For patients with weaker respiratory muscles, the resistance of the breathing trainer may be set at a level that allows the patient to complete the inhalation movement more easily, such as using a setting with a resistance coefficient of 1-2 (hypothetical resistance measurement value). During the training process, observe the patient's completion of the training movements. If the patient can easily complete each training movement and does not have abnormal manifestations such as shortness of breath and fatigue, the resistance can be gradually increased as the number of training increases, such as adjusting the resistance coefficient to 3-4 after several training sessions.

[0073] However, if the patient becomes obviously fatigued during the training, such as feeling very strenuous after completing several consecutive inhalation movements, or has abnormal respiratory function, such as a significant increase in respiratory rate and a slight decrease in blood oxygen saturation, the resistance will be appropriately reduced. During the entire training process, the resistance is always adjusted within a reasonable range where the patient can complete the training movements without excessive fatigue and affecting respiratory function, so as to gradually enhance the patient's respiratory muscle strength and promote lung function recovery.

[0074] Specifically in this solution, in the breathing exercise training, the range of motion of chest expansion and waist bending is appropriately adjusted according to the patient's body flexibility and comfort;

[0075] The phase division of the early training, mid-term training and late training can be appropriately fine-tuned according to the actual recovery condition of the patient, and the fine-tuning range is within 1-2 days.

[0076] In this embodiment: when performing breathing exercises, medical staff will fully consider the patient's body flexibility and comfort to adjust the range of chest expansion, bending, etc. For young patients with good body flexibility, the chest expansion movement can require the arms to be spread out to the sides as much as possible to achieve a greater degree of chest expansion; the bending movement can allow the hands to be as close to the feet as possible.

[0077] However, for patients with poor body flexibility or those who are older or weaker after surgery, the amplitude of the chest expansion movement will be appropriately reduced. For example, the arms can be stretched to a degree that feels slightly stretched but not painful. The bending movement also only requires the patient to bend over to a comfortable position as much as possible to avoid excessive bending over, which may cause waist discomfort or affect breathing. During the training process, medical staff will ask the patient about their feelings and adjust the amplitude of the movement in time according to the patient's feedback to ensure that the breathing exercise training can effectively exercise the respiratory muscles and thoracic movement ability without causing physical discomfort to the patient.

[0078] Regarding the division of early, mid-term and late training stages, medical staff will pay close attention to the actual recovery of patients and make appropriate fine-tuning. For example, for patients with good recovery, if on the third day of early training (1-3 days after surgery), the patient's respiratory function has been significantly improved, such as normal respiratory rate, stable blood oxygen saturation, and ease during abdominal breathing and pursed lip breathing training, then it can be considered to enter the mid-term training stage in advance.

[0079] On the contrary, if the patient recovers slowly after surgery, and still feels labored breathing and has difficulty completing deep breathing training and incentive spirometer training even on the sixth day of the mid-term training phase (4-7 days after surgery), the early training time can be appropriately extended by 1-2 days to continue consolidating basic breathing training, and then enter mid-term training when the patient's physical condition allows. Similarly, in the transition between the mid-term and late training phases, flexible adjustments will be made within a range of 1-2 days before and after based on the patient's actual recovery performance, in order to better adapt to individual differences in patients and promote effective recovery of lung function.

[0080] Finally, it should be noted that the above description is only a preferred embodiment of the present invention and is not intended to limit the present invention. Although the present invention has been described in detail with reference to the aforementioned embodiments, those skilled in the art can still modify the technical solutions described in the aforementioned embodiments or replace some of the technical features therein by equivalents. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present invention shall be included in the protection scope of the present invention.

Claims

1. A breathing training method for rapid recovery of lung function after general thoracic surgery, characterized in that: The following steps are involved: S1. Preoperative evaluation: Measure the patient's vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximum ventilation volume (MVV) parameters, and comprehensively evaluate the initial state of the patient's lung function in combination with the patient's age, the presence of underlying diseases, and the type of surgery; the underlying diseases include chronic obstructive pulmonary disease and cardiovascular disease; the types of surgery include lung wedge resection, lobectomy, pneumonectomy, and esophageal surgery; S2. Observe the lung anatomy through chest X-ray and CT scan to check the lung texture, the presence of bullae, emphysema and the condition of lung tissue around the surgical area; Training plan formulation: According to the preoperative evaluation results, a personalized breathing training plan is formulated for the patient, and the training plan is divided into three stages: early, middle and late. Among them, if the patient has good preoperative lung function, is young and the surgical trauma is small, the training plan will be relatively radical; if the patient has poor preoperative lung function, is old and weak or the surgical scope is large, the training will start with a moderate intensity and gradually increase the intensity; S3. Phased breathing training: Early training (1-3 days after surgery): Abdominal breathing training: The patient lies on his back, relaxes the whole body, puts one hand on the chest and the other hand on the abdomen, inhales slowly through the nose to make the abdomen bulge, and the hand on the abdomen rises accordingly, and the hand on the chest keeps still as much as possible, and then exhales slowly through the mouth to make the abdomen contract and sink. Each training lasts 10-15 minutes, 3-4 times a day; Pursed lip breathing training: The patient closes his mouth and inhales through the nose, then purses his lips and exhales slowly in a whistle-like manner. The exhalation time is 2-3 times the inhalation time. Each training lasts 10-15 minutes, 3-4 times a day. Mid-term training (4-7 days after surgery): Deep breathing training: The patient is in a comfortable position, takes a slow, deep breath to fully expand the chest, and then exhales slowly. The ratio of inhalation to exhalation time is about 1:

2. Each training session lasts 15-20 minutes, and the training is done 3-4 times a day. Incentive spirometer training: The patient holds the incentive spirometer, holds the mouthpiece after normal exhalation, and slowly and deeply inhales to make the piston in the spirometer reach the preset target value, and maintains it for a period of time, 5-6 sets a day, 10-12 times each set; Late training (8 days after surgery - before discharge): Resistance breathing training: patients use a breathing trainer with adjustable resistance to overcome the set resistance when inhaling. Each training session lasts 20-30 minutes, and the training is performed 2-3 times a day. Breathing exercise training: The patient stands, clenches his fists, stretches his arms forward, expands his chest to both sides and takes a deep breath, then bends over and touches his feet with both hands while exhaling, and inhales when standing up. Each breathing exercise lasts 20-30 minutes, 2-3 times a day; Training supervision and adjustment steps: During the training process, medical staff monitor the patient's respiratory rate, depth, and blood oxygen saturation parameters, and ask the patient about his or her subjective feelings; if the patient experiences shortness of breath or a sharp drop in blood oxygen saturation, the training will be suspended, and after the patient's condition stabilizes, the training intensity will be reduced or the training method will be modified.

2. A breathing training method for rapid recovery of lung function after general thoracic surgery according to claim 1, characterized in that: During the abdominal breathing training, the amplitude of the abdominal bulge is adjusted according to the patient's tolerance to ensure the effectiveness and safety of the breathing training.

3. A breathing training method for rapid recovery of lung function after general thoracic surgery according to claim 2, characterized in that: In the pursed lip breathing training, the ratio of exhalation time to inhalation time is adjusted according to the patient's tolerance and breathing conditions, but the exhalation time is always maintained at 2-3 times the inhalation time.

4. A breathing training method for rapid recovery of lung function after general thoracic surgery according to claim 3, characterized in that: In the incentive spirometer training, the preset target value is adjusted according to the patient's preoperative lung function assessment results and the current training stage.

5. A breathing training method for rapid recovery of lung function after general thoracic surgery according to claim 4, characterized in that: In the resistance breathing training, the resistance is adjusted according to the patient's training progress and respiratory muscle strength, and the resistance range is within a range that allows the patient to complete the training movements without causing excessive fatigue and abnormal respiratory function.

6. A breathing training method for rapid recovery of lung function after general thoracic surgery according to claim 5, characterized in that: In the breathing exercise training, the range of motion of chest expansion and waist bending is appropriately adjusted according to the patient's body flexibility and comfort; The phase division of the early training, mid-term training and late training can be appropriately fine-tuned according to the actual recovery condition of the patient, and the fine-tuning range is within 1-2 days.