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　　肿瘤治疗专家介绍，肺癌是肺部常见的恶性肿瘤，而传统的治疗方法主要是手术治疗(肺叶或全部切除)。而一般术后常出现暂时的呼吸功能低下以及由于手术创伤，那么很多患者都很担心肺癌患者如何才能恢复呼吸功能。

　　一、术前呼吸功能的训练与指导
　　1、术前教育：对有吸烟史患者解释吸烟对健康和手术的危害，术前绝对戒烟1周。并解释清楚麻醉和手术引起的呼吸反应，术后可能出现的并发症以及术后卧床不活动对呼吸的影响，使患者认识到进行呼吸功能锻炼的重要性，从而积极配合。
　　2、指导患者学会深呼吸法，分别坐位练习胸式深呼吸和平卧位练习腹式深呼吸，每日2-3次，每次15min左右。术前1周开始进行，并进行适当的体育锻炼，以增加肺活量。
　　3、学习有效的咳嗽方法，指导患者深吸气后，用胸腹部的力量作最大咳嗽，咳嗽的声音应以胸部震动而发出，每日练习3次，每次20次左右。向患者解释通过有效咳嗽，可预防肺不张、肺部感染。
　　4、指导患者进行肺功能扩充器的训练。本组患者各配1个肺功能扩充训练器，训练器上有刻度可显示每次吸气的气量，容易引起患者兴趣。嘱患者取坐位、半卧位深呼气后口含连接肺功能扩充器的喉嘴，作最大吸气。每日早晚各1次，术前1周开始进行，手术当天暂停，术后第3天后可继续进行，次数可量力而行。向患者解释通过术前肺功能扩充训练器的锻炼，可以增加患者的肺活量和最大通气量，从而改善肺功能。
　　5、对合并有慢性支气管炎、肺气肿或肺部感染的患者，按医嘱进行解痉抗炎，若痰液粘稠，不易咯出者，给予庆大霉素8万U+糜蛋白酶5 mg+生理盐水20 ml,每日2，3次，给予超声雾化吸入。

　　二、术后呼吸功能的训练与指导
　　1、充分镇痛、解除紧张和放松肌肉：术后患者常因伤口疼痛全身肌肉紧张限制呼吸，呼吸快而表浅，除应用镇痛药物外，可采取半卧位，膝下放枕头，保持姿势舒适，轻轻活动或按摩颈部和肩胛部以消除肌肉紧张，使呼吸保持适当的频率和幅度。本组15例患者全部采用术后留置硬膜外麻醉管输注镇痛药并结合肌肉放松的方法，前72 h 90%患者的呼吸次数为22～28次/min。
　　2、实施辅助呼吸活动的康复训练：随着患者的呼气动作用手压迫胸廓，这样可使吸气胸廓扩张时，增强吸气量和气流速度，又能促使支气管内分泌物的移动，胸廓也可因运动而不致僵硬，从而促进残存肺的膨胀。
　　3、指导呼吸：本组病例在麻醉清醒后均给予呼吸指导，每隔2 h进行深呼吸10～20次，平卧位加强腹式呼吸，直到48～72 h胸腔引流管拔除为止，指导呼吸有利于肺扩张，改善肺通气功能，提高肺的顺应性。
　　4、协助排痰：术前由于麻醉药物抑制咳嗽反射，加上疼痛不能有效咳嗽，尤其是有长期吸烟史者，小气道功能差，常有呼吸道潴留物，痰液较多，需协助排痰。患者取坐位，操作者站床边，手掌呈杯状，叩打与痰部位相应的胸壁，并同时鼓励患者咳嗽，并用双手掌按压术侧胸廓，吸气时双手放松，咳嗽时双手加压，以保护伤口，减少胸壁震动引起的切口疼痛。对个别咳嗽无力的患者，还可采用鼻导管吸引气管，刺激产生有效咳嗽，以排出分泌物。若上述的方法均无效，患者的呼吸道分泌物又较多时，可采用通过支气管纤维镜下吸痰的方法。本组有3例老年患者出现咳嗽无力，经用纤支镜下吸痰，效果良好。另外，本组患者全部采用超声波雾化吸入，用雾化器把祛痰剂、解痉剂、消炎剂变成微小的气雾，随着病人的吸气而进入呼吸道，使气道湿度合适，达到祛痰、消炎、解痉的作用。
　　5、早期运动训练：早期活动可预防坠积性肺炎及下肢静脉血栓形成，手术日麻醉恢复后，即可指导并协助患者开始活动。有的患者术后因创口疼痛或担心创口裂开而不愿运动，所以，应充分说明全身性功能训练的必要性，在上肢和肩关节进行活动范围内的练习，从术后第1天起用健侧握住系在床尾栏上的绷带自行坐起，术后48～72h拔管后可下床在室内活动。

　　肿瘤治疗专家介绍，肺癌是肺部常见的恶性肿瘤，而传统的治疗方法主要是手术治疗(肺叶或全部切除)。而一般术后常出现暂时的呼吸功能低下以及由于手术创伤，那么很多患者都很担心肺癌患者如何才能恢复呼吸功能。

　　一、术前呼吸功能的训练与指导
　　1、术前教育：对有吸烟史患者解释吸烟对健康和手术的危害，术前绝对戒烟1周。并解释清楚麻醉和手术引起的呼吸反应，术后可能出现的并发症以及术后卧床不活动对呼吸的影响，使患者认识到进行呼吸功能锻炼的重要性，从而积极配合。
　　2、指导患者学会深呼吸法，分别坐位练习胸式深呼吸和平卧位练习腹式深呼吸，每日2-3次，每次15min左右。术前1周开始进行，并进行适当的体育锻炼，以增加肺活量。
　　3、学习有效的咳嗽方法，指导患者深吸气后，用胸腹部的力量作最大咳嗽，咳嗽的声音应以胸部震动而发出，每日练习3次，每次20次左右。向患者解释通过有效咳嗽，可预防肺不张、肺部感染。
　　4、指导患者进行肺功能扩充器的训练。本组患者各配1个肺功能扩充训练器，训练器上有刻度可显示每次吸气的气量，容易引起患者兴趣。嘱患者取坐位、半卧位深呼气后口含连接肺功能扩充器的喉嘴，作最大吸气。每日早晚各1次，术前1周开始进行，手术当天暂停，术后第3天后可继续进行，次数可量力而行。向患者解释通过术前肺功能扩充训练器的锻炼，可以增加患者的肺活量和最大通气量，从而改善肺功能。
　　5、对合并有慢性支气管炎、肺气肿或肺部感染的患者，按医嘱进行解痉抗炎，若痰液粘稠，不易咯出者，给予庆大霉素8万U+糜蛋白酶5 mg+生理盐水20 ml,每日2，3次，给予超声雾化吸入。

　　二、术后呼吸功能的训练与指导
　　1、充分镇痛、解除紧张和放松肌肉：术后患者常因伤口疼痛全身肌肉紧张限制呼吸，呼吸快而表浅，除应用镇痛药物外，可采取半卧位，膝下放枕头，保持姿势舒适，轻轻活动或按摩颈部和肩胛部以消除肌肉紧张，使呼吸保持适当的频率和幅度。本组15例患者全部采用术后留置硬膜外麻醉管输注镇痛药并结合肌肉放松的方法，前72 h 90%患者的呼吸次数为22～28次/min。
　　2、实施辅助呼吸活动的康复训练：随着患者的呼气动作用手压迫胸廓，这样可使吸气胸廓扩张时，增强吸气量和气流速度，又能促使支气管内分泌物的移动，胸廓也可因运动而不致僵硬，从而促进残存肺的膨胀。
　　3、指导呼吸：本组病例在麻醉清醒后均给予呼吸指导，每隔2 h进行深呼吸10～20次，平卧位加强腹式呼吸，直到48～72 h胸腔引流管拔除为止，指导呼吸有利于肺扩张，改善肺通气功能，提高肺的顺应性。
　　4、协助排痰：术前由于麻醉药物抑制咳嗽反射，加上疼痛不能有效咳嗽，尤其是有长期吸烟史者，小气道功能差，常有呼吸道潴留物，痰液较多，需协助排痰。患者取坐位，操作者站床边，手掌呈杯状，叩打与痰部位相应的胸壁，并同时鼓励患者咳嗽，并用双手掌按压术侧胸廓，吸气时双手放松，咳嗽时双手加压，以保护伤口，减少胸壁震动引起的切口疼痛。对个别咳嗽无力的患者，还可采用鼻导管吸引气管，刺激产生有效咳嗽，以排出分泌物。若上述的方法均无效，患者的呼吸道分泌物又较多时，可采用通过支气管纤维镜下吸痰的方法。本组有3例老年患者出现咳嗽无力，经用纤支镜下吸痰，效果良好。另外，本组患者全部采用超声波雾化吸入，用雾化器把祛痰剂、解痉剂、消炎剂变成微小的气雾，随着病人的吸气而进入呼吸道，使气道湿度合适，达到祛痰、消炎、解痉的作用。
　　5、早期运动训练：早期活动可预防坠积性肺炎及下肢静脉血栓形成，手术日麻醉恢复后，即可指导并协助患者开始活动。有的患者术后因创口疼痛或担心创口裂开而不愿运动，所以，应充分说明全身性功能训练的必要性，在上肢和肩关节进行活动范围内的练习，从术后第1天起用健侧握住系在床尾栏上的绷带自行坐起，术后48～72h拔管后可下床在室内活动。

==== 汉译英 ====
Cancer treatment experts, lung cancer is a common lung cancer, and traditional methods of treatment is surgery (lobectomy or total removal). Often appear after the general temporary respiratory dysfunction as a result of surgical trauma, so many patients are worried about the lung cancer patients how to restore respiratory function.

A, preoperative respiratory function of training and guidance
1 Preoperative education: patients with a history of smoking and to explain the operation of smoking on health hazards, the absolute quit smoking 1 week before surgery. And to explain the anesthesia and surgery induced respiratory reactions may occur after surgery and postoperative complications of bed rest did not influence the activities of respiration, so that patients recognize the importance of respiratory function exercises to actively cooperate.
2, guiding patients learn deep breathing method were sitting chest deep breathing exercises to practice peace and supine abdominal deep breathing 2-3 times a day, every 15min or so. Started 1 week before surgery, and appropriate physical exercise to increase lung capacity.
3, cough and effective method of learning, instruction, after deep inspiration in patients with chest and abdomen for maximum strength cough, cough, chest vibrating voice should be issued, exercise 3 times a day, each about 20 times. Explained to the patient through effective cough, can prevent atelectasis, lung infection.
4, guiding patients with pulmonary expander training. This group of patients with a lung function of the expansion of training devices, training devices can be displayed on each scale of the gas suction, easy to cause patient interest. Zhu Huanzhe take seats, deep breath half supine pulmonary function after the expansion port connector with hose nozzle device for maximum suction. 1 day sooner or later, started 1 week before surgery, suspended the day of surgery, 3 days after operation may continue, the number may be within our capabilities. Explained to the patient through the preoperative pulmonary function expansion trainer exercise, can increase the patient's vital capacity and maximum ventilation to improve lung function.
5, combined with chronic bronchitis, emphysema or lung infection in patients with spasm by your doctor for anti-inflammatory, if the sputum viscous and difficult to spit those given gentamicin 80 000 5 mg + U + chymotrypsin saline 20 ml, 2,3 times a day to give ultrasonic atomizing inhalation.

Second, the postoperative respiratory function of training and instruction
1, the full analgesic to relieve tension and relax muscles: postoperative wound pain often due to restricted breathing muscles tense, breathing fast and shallow, in addition to application of analgesic drugs, can be taken semi-supine, knees put the pillow, hold the position comfort, activity or gently massage the neck and scapular muscles to remove tension, the respiratory frequency and amplitude to maintain appropriate. All 15 patients in this group with postoperative indwelling epidural analgesic infusion tube combined with muscle relaxation method, the first 72 h 90% of patients with respiratory rate of 22 ~ 28 times / min.
2, the implementation of rehabilitation activities assisted breathing: With the breath of patients with chest oppression, hand movements, which can make breathing chest expansion, the increased volume and inspiratory flow rate, bronchial secretions and can facilitate the movement of the thorax may also be due to movement without stiffness, thus promoting the expansion of residual lung.
3, the respirator: All the patients were given anesthesia, conscious breathing guide, take a deep breath every 2 h for 10 to 20 times a supine position to strengthen abdominal breathing, until 48 ~ 72 h until the chest drain removal, guidance breathing conducive to lung expansion, improved lung function, increased lung compliance.
4, to assist expectoration: Preoperative narcotic drugs inhibit the cough reflex, plus the pain is not an effective cough, especially those with long-term smoking history, small airway function is poor, often respiratory retention properties, sputum are more in need of assistance row sputum. Patients were seated, the operator station beside the bed, palms were cup, with sputum percussion parts corresponding chest wall, and also encourage patients to cough, and hand massage for double side thorax, hands relaxed when breathing, coughing pressure with both hands to protect the wound and reduce the vibration caused the chest wall incision pain. Inability of individual patients with cough, nasal cannula can be used to attract the trachea, stimulate the production of effective cough, to drain secretions. If the above methods are ineffective, the patient's respiratory secretions and large, the microscopic fibers can be used by bronchial suction method. The group of 3 elderly patients unable to cough, the use of bronchoscopy under suction, good effect. In addition, all patients with ultrasonic aerosol inhalation, the nebulizer used expectorant, antispasmodic agents, anti-inflammatory agent into a small aerosol, with the patient's breathing and into the respiratory tract, so that the airway humidity appropriate to expectorant, anti-inflammatory, antispasmodic effect.
5, the early exercise training: early activity can prevent hypostatic pneumonia and deep vein thrombosis, the day of surgery after anesthesia, to guide and assist the patient to begin activities. Some patients due to wound dehiscence wound pain or fear rather than sport, so should fully explain the need for systemic functional training, in the upper limb and shoulder exercises within the scope of activities, from the only use on postoperative day 1 Department of contralateral hold bandages in their own end of the bed sat up on the field, 48 ~ 72h after extubation can get out of bed in the room after the event.