快速康复外科理念对单孔胸腔镜肺叶切患者术后应激因子、肺功能及疼痛评分的影响  

Effect of Fast Track Surgery on Stress Factors, Lung Function and Pain Score in Patients Undergoing Single Port Thoracoscopic Lobectomy

作　　者：许哲源[1] 张利斌[1] 汪洋 陈云 刘俊[1] 熊健[1] 彭浩[1] XU Zhe-yuan;ZHANG Li-bin;WANG Yang;CHEN Yun;LIU Jun;XIONG Jian;PENG Hao(Department of Thoracic Surgery,Yunnan First People's Hospital/Affiliated Hospital of Kunming University of Technology,Kunming,Yunnan,650032,China)

机构地区：[1]云南省第一人民医院/昆明理工大学附属医院胸外科,云南昆明650032

出　　处：《现代生物医学进展》2022年第2期329-332,396,共5页Progress in Modern Biomedicine

基　　金：云南省科技厅-昆明医科大学联合专项(2019FE001-115);云南省卫健委内设机构课题(2018NS0271);云南省第一人民医院临床医学中心开放课题(2021LCZXXF-HX11)。

摘　　要：目的:探讨快速康复外科理念(FTS)对单孔胸腔镜肺叶切除患者术后应激因子、肺功能及疼痛评分的影响。方法:选择2018年5月~2020年12月期间我院收治的单孔胸腔镜肺叶切除患者117例,根据随机数字表法将患者分为对照组(58例)和研究组(59例),对照组给予常规干预,研究组给予FTS干预。对比两组手术指标、应激因子、肺功能、疼痛评分及并发症。结果:研究组的胸管留置时间、术后排气时间、卧床时间、住院时间均短于对照组(P<0.05)。两组术后5 d C反应蛋白(CRP)、白细胞介素-6(IL-6)、皮质醇(Cor)升高,但研究组的升高幅度更低(P<0.05)。两组术后5 d第一秒最大呼气量(FEV1)、用力肺活量(FVC)、最大通气量(MVV)升高,且研究组的升高幅度更高(P<0.05)。研究组术后4 h、24 h、48 h的视觉疼痛模拟量表(VAS)评分低于对照组(P<0.05)。研究组的并发症总发生率低于对照组(P<0.05)。结论:FTS应用于单孔胸腔镜肺叶切除术可有效减轻术后应激,减轻患者疼痛,促进患者肺功能恢复,降低并发症发生风险。Objective:To investigate the effect of fast track surgery(FTS)on stress factors,lung function and pain score in patients undergoing single port thoracoscopic lobectomy.Methods:117 patients with single port thoracoscopic lobectomy who were treated in our hospital from May 2018 to December 2020 were selected,and they were randomly divided into control group(58 cases)and study group(59 cases)by the random number table method.The control group was given routine intervention,and the study group was given FTS intervention.The operation indexes,stress factors,lung function,pain score and complications were compared between the two groups.Results:The chest tube indwelling time,postoperative exhaust time,bed rest time and hospitalization time of the study group were shorter than those of the control group(P<0.05).The C-reactive protein(CRP),interleukin-6(IL-6),cortisol(Cor)of the two groups at 5 d after operation increased,but the increase of the study group was lower(P<0.05).Maximum expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximum ventilation volume(MVV)of the two groups at 5 d after operation increased,and the increase of the study group was higher(P<0.05).The visual analogue scale(VAS)scores of the study group at 4 h,24 h and 48 h after operation were lower than those of the control group(P<0.05).The total incidence of complications of the study group was lower than that of the control group(P<0.05).Conclusion:FTS used in single port thoracoscopic lobectomy can effectively reduce postoperative stress,relieve pain of patients,promote the recovery of lung function,and reduce the risk of complications.

关 键 词：快速康复外科理念 单孔胸腔镜肺叶切除 应激因子 肺功能 疼痛评分 

分 类 号：R655.3[医药卫生—外科学] R734.2[医药卫生—临床医学]