| 李雪丹,薛荣亮,武 辉,陈 皎,米卫国.加速康复外科联合全胸腔镜在肺癌根治术患者中的应用研究[J].,2018,(20):3874-3878 |
| 加速康复外科联合全胸腔镜在肺癌根治术患者中的应用研究 |
| Application of Enhanced Recovery after Surgery Combined with Full Thoracoscopy in Patients with Radical Resection of Lung Cancer |
| 投稿时间：2018-04-16 修订日期：2018-05-12 |
| DOI：10.13241/j.cnki.pmb.2018.20.016 |
| 中文关键词: 加速康复外科 全胸腔镜 肺癌根治术 临床效果 |
| 英文关键词: Enhanced recovery after surgery Full thoracoscopy Radical resection of lung cancer Effect |
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| 中文摘要: |
| 摘要 目的：探讨加速康复外科（ERAS）联合全胸腔镜在肺癌根治术患者中的应用效果。方法：选择2015年5月-2017年5月西安交通大学第二附属医院收治的肺癌患者80例，根据随机数字表法将其分为对照组（n=40）与研究组（n=40）。两组患者均采取常规单操作孔全胸腔镜肺癌根治术治疗，对照组实施传统围手术期处理方法，研究组则应用ERAS模式进行围术期干预。评价两组患者术后各项临床指标、术后全身炎症反应综合征（SIRS）发生率及并发症发生情况，对比两组患者术后1d、3d、5d的视觉模拟量表（VAS）评分，以及术前、术后3d的C反应蛋白（CRP）水平。结果：研究组术后胸腔引流量、术后首次进食时间、术后住院天数、胸腔引流管拔除时间均低于对照组（P<0.05）。研究组术后SIRS、并发症发生率分别为0.00%、5.00%，均低于对照组的15.00%、22.50%，差异有统计学意义（P<0.05）。两组患者术后3d、术后5d VAS评分均低于术后1d，且两组患者术后5d VAS评分低于术后3d（P<0.05），研究组术后1d、3d与5d的VAS评分均低于对照组（P<0.05）。术前两组CRP水平对比差异无统计学意义（P<0.05），两组患者术后3d CRP水平高于术前，且研究组CRP水平显著低于对照组（P<0.05）。结论：对于肺癌根治术患者，ERAS联合全胸腔镜可减轻患者疼痛，降低炎症因子水平，不良反应少，对患者早期康复具有良好的效果，值得临床推广。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of enhanced recovery after surgery (ERAS) combined with full thoracoscopy in patients with radical resection of lung cancer. Methods: Selected 80 patients with lung cancer who were treated in The Second Affiliated Hospital of Xi'an Jiaotong University from May 2015 to May 2017, and they were divided into the control group (n=40) and the study group (n=40) according to the random number table method. The patients in two groups were treated by conventional single operation hole full thoracoscopic radical resection of lung cancer. The control group were received traditional perioperative treatment, while the study group were received perioperative intervention of ERAS model. The clinical indicators, the incidence of systemic inflammatory response syndrome (SIRS) after operation and the incidence of complications in two groups were observed and evaluated, the score of visual analogue scale (VAS) in the two groups at 1d, 3d and 5d after operation were compared, and the level of C reactive protein (CRP) before operation and 3d after operation was compared. Results: Postoperative thoracic drainage volume, postoperative the first feeding time, postoperative hospitalization days and extraction time of thoracic drainage tube in study group were all lower than those in control group (P<0.05). The incidence of SIRS and complications after operation in the study group was 0.00% and 5.00% respectively, which were lower than 15.00% and 22.50% in the control group,and the difference was statistically significant (P<0.05). The scores of VAS 3d and 5d after operation in the two groups were lower than that of 1d after operation, and the scores of VAS 5d after operation in the two groups were lower than 3d after operation (P<0.05), the scores of VAS 1d, 3d and 5d after operation in the study group were lower than those of the control group (P<0.05). There was no significant difference in the level of CRP between the two groups before operation (P>0.05). The level of 3d CRP in the two groups was higher than that before operation, and the level of CRP in the study group was significantly lower than that of the control group (P<0.05). Conclusion: For patients with radical resection of lung cancer, ERAS combined with thoracoscopy can reduce pain, reduce the levels of inflammatory factors, and reduce adverse reactions. It has good effect on early rehabilitation of patients, which is worthy of clinical promotion. |
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