The effect of Acapella trainer on respiratory function of patients after thoracoscopic lung cancer surgery

To investigate the effect of Acapella training on respiratory function in patients undergoing video‐assisted thoracic surgery (VATS).


| INTRODUCTION
Lung cancer ranks the first in malignant tumor incidence and cause of death. 1 The treatment methods of lung cancer include surgery, immunotherapy, and targeted therapy. At present, there are thoracoscopic surgery and open surgery. With the improvement of surgical instruments and surgical techniques, thoracoscopic surgery has become the main surgical method. 2 Video-assisted thoracic surgery (VATS) provides a new method and means for the diagnosis and treatment of chest diseases, which has the advantages of less trauma and faster recovery, and is increasingly widely used in clinical practice. 3 However, postoperative complications such as pulmonary infection and atelectasis often occur. 4 Postoperative sputum retention and weakened respiratory muscle strength are the major contributing factors to the high incidence of postoperative respiratory complications in patients with lung cancer. 5 There is no doubt that rapid and effective clearance of respiratory secretions and scientific and correct respiratory training have positive effects on the prevention of pulmonary complications after lung cancer surgery. 6 Acapella is a new type of vibration positive pressure expiratory device, which has the effect of promoting sputum excretion and opening the airway, and has certain curative effect in the treatment of senile chronic obstructive pulmonary disease. 7 In this study, Acapella trainer was used to train the respiratory function of patients, and good results were achieved. It is reported as follows: (4) Other reasons for withdrawal during the test; (5) Incomplete data.

| METHODS
According to the random number table method, the patients were divided into two groups. Before surgery, all patients were given routine nursing, and after surgery, patients in the control group were given routine pulmonary rehabilitation exercise. On this basis, patients in the observation group were given Acapella trainers. There was no statistically significant difference in general data between the two groups (P >.05), which is comparable. Approved by the Ethics Committee of Jiangsu Cancer Hospital, all patients signed informed consent after informing the study matters. General information of patients in the two groups is shown in Table 1.  After the patient gradually ADAPTS to the device, the initial resistance can be adjusted to 4 to 5 gear.

| Observation indicators
The respiratory function and postoperative hospital stay of the two groups were compared before and 30 days after operation. Respiratory function was determined according to the lung function indicators before and after intervention, including FVC, FEV1, and PEF.

| Statistical analysis
The SPSS 22.0 software was used for statistical analysis. Measurement data such as respiratory function and postoperative hospital stay were represented by (x ± s), and comparison between groups was performed by T test. The difference was statistically significant (P <.05).

| RESULT
There were no statistically significant differences in lung function FVC, FEV1 and PEF between the two groups at admission (P <.05).
The differences in the above indicators were statistically significant between the two groups at 30 days after surgery and at admission (P <.05).The differences of FEV1, FVC, and PEF between the two groups after Acapella treatment were statistically significant (P = .04, P = .047, P = .047), as shown in Table 2.

| DISCUSSION
Thoracoscopic surgery has the advantages of fewer complications, less trauma and faster recovery, such as less chest muscle injury, no rib distraction, preservation of thoracic integrity, and no injury to intercostal nerves and muscles. 8