快速康复外科在中量创伤性血胸治疗中应用的可行性和有效性分析  

Analysis of the feasibility and effectiveness of the application of rapid rehabilitation surgery in treatment of moderate amount of traumatic hemothorax

作　　者：漆奋强[1] 向敏峰[1] 李雪[1] 卢建华[1] 覃华晶 邓煜锋[1] 韦福旺 袁天柱[1] 

机构地区：[1]广西医科大学第四附属医院心胸外科,柳州545005

出　　处：《中国社区医师》2018年第2期175-176,共2页Chinese Community Doctors

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(编号Z2016180和Z20170910)资助~~

摘　　要：目的:探析在中量创伤性血胸治疗中融入快速康复外科理念的可行性及有效性。方法:收治中量创伤性血胸患者60例,随机平分两组。研究组在快速康复外科理念下展开系列治疗措施,对照组采用传统治疗流程进行胸腔闭式引流治疗,对比两组患者治疗效果。结果:研究组治疗后24 h及72 h呼吸频率改善情况明显较对照组更优(P<0.05);术后胸腔积液预估量及实际量都较对照组更少(P<0.05);研究组患者氧合指数更高、术后1 d疼痛程度更轻(P<0.05);研究组并发症发生率3.3%,明显低于对照组的20%(P=0.044);和对照组相比,研究组带管及住院时间更短,而花费相对较多(P<0.05)。结论:在中量创伤性血胸治疗中应用快速康复外科概念,术前心理干预能降低患者手术应激反应,营养支持、合理抗生素应用等能促进病情康复,总的来说应用快速康复外科理念具有一定的可行性和有效性。Objective：To investigate the feasibility and effectiveness of the application of rapid rehabilitation surgery in treatment of moderate amount of traumatic hemothorax.Methods：60 patients with moderate amount of traumatic hemothorax were selected.They were randomly divided into the two groups on average.The study group launched a series of treatment measures under the concept of rapid rehabilitation surgery.The control group was treated with the traditional treatment process for closed thoracic drainage.We compared the therapeutic effect of patients in the two groups.Results：The improvement of respiratory rate of 24 h and72 h in the study group was better than that of the control group（P〈0.05）.The prognosis of the pleural effusion was less than that of the control group after the operation（P〈0.05）.The patients in the study group had higher oxygenation index and less pain after1 day of operation（P〈0.05）.The incidence of complications in the study group was 3.3% lower than that of the control group of 20%（P=0.044）.Compared with the control group,the study group had shorter time of tube and hospitalization,and the cost was relatively more than that of the control group（P〈0.05）.Conclusion：The application of fast track surgery concept in treatment of moderate amount of traumatic hemothorax,preoperative psychological intervention can reduce the surgical stress response of patients.Nutritional support,rational application of antibiotics can promote the recovery of the patients.General concept is feasible and effective.

关 键 词：快速康复外科 中量创伤性血胸 有效性 可行性 

分 类 号：R473.6[医药卫生—护理学]