目的 评估综合物理治疗对肺癌合并慢性阻塞性肺疾病（简称慢阻肺）患者肺切除术或叶切除术后肺功能的影响。 方法 选取 2005 年 1 月至 2014 年 5 月因肺癌接受肺切除术或肺叶切除术的慢阻肺合并肺癌患者，根据术前是否接受物理治疗分为综合物理治疗组（A 组，55 例）和未接受综合物理治疗组（B 组，43 例）。比较 A 组入院时（T1 时间点）和综合物理治疗后（T2 时间点）的肺功能的变化，同时比较 A、B 两组患者手术后（T3 时间点）肺功能和临床特征的变化。 结果 A 组患者进行术前综合物理治疗后第 1 秒用力呼气容积（FEV1）、肺活量（VC）、50% 肺活量位最大呼气流速（FEF50）和 25% 肺活量位最大呼气流速（FEF25）比基线值分别增加 16.96%、14.75%、20.69% 和 13.79%，6 分钟步行距离得到显著改善。术后 FEV1 和 VC 显著降低，小气道功能和临床特征显著恶化，在 Δ[T2-T1] 阶段，不同程度 FEV1%pred 患者间肺功能变化差异无统计学意义；在 Δ[T2-T3] 阶段，FEV1%pred≥80% 患者和 50%≤FEV1%pred<80% 患者 FEF50 和 FEF25 变化程度大于 FEV1%pred<50% 的患者。肺叶切除术患者肺功能 B 组患者低于 A 组患者（FEV1：10.24% vs. 22.44%；VC：10.13% vs. 20.87%）；在肺切除术患者中也存在相似的差异，但差异较小（FEV1：36.33% vs. 36.78%；VC：37.23% vs. 38.98%）。 结论 综合物理治疗对于改善肺癌合并慢阻肺患者肺切除术或叶切除术后肺功能有重要意义
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