加速康复外科应用于肺癌手术患者的术后效果及安全性分析  

Effect and safety of enhanced recovery after surgery in patients with lung cancer

作　　者：洪祎纯[1] 蔡南[1] 杨晓瑜[1] 张欢楷[1] 黄加铭 黄豪达[1] 张志锋[1] HONG Yi-chun;CAI Nan;YANG Xiao-yu;ZHANG Huan-kai;HUANG Jia-ming;HUANG Hao-da;ZHANG Zhi-feng(Department of Cardiothoracic Surgery,Jieyang People's Hospital,Jieyang,Guangdong 522000,China)

机构地区：[1]揭阳市人民医院胸心外科,广东揭阳522000

出　　处：《临床肺科杂志》2019年第4期610-613,共4页Journal of Clinical Pulmonary Medicine

基　　金：广东省揭阳市科技计划项目(No 2017YL015)

摘　　要：目的研究对肺癌手术的患者应用加速康复外科(ERAS)方法的效果和安全性。方法选择2017年2月至2018年2月入住我院130例肺癌患者作为研究对象,根据数字法随机分为观察组及对照组,每组65例,观察组应用ERAS,对照组应用传统的治疗模式,分别比较两组患者手术后并发症发生率、疼痛程度、恢复速度快慢、手术后第一次下床活动以及进食的时间、胸管停留时间、平均住院时间、费用和抗生素使用时间。结果观察组第一次下床活动及进食的时间、胸管停留时间、恢复时间和抗生素使用时间均低于对照组(P<0.05);住院时间以及住院使用的费用均低于对照组(P<0.05);术后6h,1天,数字评分法(NRS)评分均低于对照组,但差异无统计学的意义(P>0.05),术后2天,3天,4天,5天NRS评分低于对照组(P<0.05);术后出现不良反应概率低于对照组(P<0.05)。结论本研究通过加速康复外科在肺癌手术治疗中的应用,从术后并发症、疼痛程度、恢复速度、首次下床活动及进食时间、胸管停留时间、平均住院时间、费用及抗生素使用时间等方面,与传统模式作对比,显示出ERAS治疗的优越性,同时为胸外科围手术期管理提供新理念。Objective To study the efficacy and safety of enhanced recovery after surgery(ERAS)for patients undergoing lung cancer surgery.Methods 130 patients with lung cancer admitted to our hospital from February 2017 to February 2018 were selected as study subjects,and they were randomly divided into the observation group and the control group,65 patients in each group.The observation group was treated with ERAS,and the control group was treated with traditional nursing mode.The incidence of postoperative complications,the degree of pain,the speed of recovery,the first time of getting out of bed and the time of eating after operation,the time of chest tube stay,the average hospitalization time,the cost and the time of antibiotic use were compared between the two groups.Results The time of the first time of getting out of bed and eating,the time of chest tube stay,the time of recovery and the time of using antibiotics in the observation group were lower than those in the control group(P<0.05).The duration of hospital stay and the cost of hospitalization were lower in the observation group than in the control group(P<0.05).The NRS scores were lower in the observation group than in the control group at 6 hours after operation.However,there was no significant difference in NRS score with the control group at 6 hours after operation(P>0.05).The NRS scores were significantly lower in the observation group than in the control group(P<0.05).The incidence of adverse reactions was lower in the observation group than in the control group(P<0.05).Conclusion By accelerating the application of ERAS in the surgical treatment of lung cancer,this study includes postoperative complications,degree of pain,recovery speed,first time of getting out of bed and eating time,time of chest tube stay,average time of hospitalization,cost and duration of use of antibiotics,etc.Compared with the traditional model,the superiority of ERAS treatment is determined,and can provide a new idea for thoracic surgery.

关 键 词：加速康复外科理念 肺癌 手术 术后效果 安全性 

分 类 号：R473.73[医药卫生—护理学]