加速康复外科理念在胸腔镜下肺大疱切除术后的应用  

The application of enhanced recovery after surgery theory after thoracoscopic pulmonary bullae resection

作　　者：李春 帕合尔丁·买买提 边拜 LI Chun;PAHEERDING·Maimaiti;BIAN Bai(Department of Thoracic Surgery,Urumqi Youai Hospital,Urumqi 830002,Xinjiang,China)

机构地区：[1]乌鲁木齐友爱医院胸外科,新疆乌鲁木齐830002

出　　处：《吉林医学》2022年第4期899-902,共4页Jilin Medical Journal

基　　金：乌鲁木齐友爱医院院级科技计划项目[项目编号:202007]。

摘　　要：目的:应用加速康复外科理念(ERAS),探讨胸腔镜肺大疱切除术后不放置胸腔闭式引流管的可行性和安全性。方法:将60例行胸腔镜肺大疱切除的患者采用随机数字表法分为ERAS组和对照组。其中术后不放置胸管的ERAS组有28例,术后放置胸管的对照组有32例。比较两组患者术后24 h、48 h、72 h疼痛评分,术后下床活动时间,并发症发生率,术后住院时间,总住院费用等。结果:ERAS组术后24 h、48 h、72 h疼痛评分均明显低于对照组[(2.82±1.13)分vs(5.12±1.74)分、(1.92±0.83)分vs(3.93±1.48)分和(1.01±0.44)分vs(2.03±0.63)分],差异有统计学意义(P<0.05)。ERAS组术后至下床活动时间明显低于对照组[(1.81±0.47)d vs(3.23±1.63)d],差异有统计学意义(P<0.05)。ERAS组术后并发症发生率低于对照组[14.3%(4/28)vs 37.5%(12/32)],差异有统计学意义(P<0.05)。ERAS组术后住院时间低于对照组[(4.35±1.42)d vs(6.23±1.76)d],差异有统计学意义(P<0.05)。ERAS组住院费用低于传统组[(1.65±0.42)万元vs(1.92±0.57)万元],差异有统计学意义(P<0.05)。结论:在严格筛选的胸腔镜肺大疱切除术患者中,术后不放置胸管是可行的、安全的,有利用患者加速康复。Objective To explore the feasibility and safety of thoracoscopic bullectomy without thoracic closed drainage tube according to the enhanced recovery after surgery theory.Method A total of 60 patients who underwent thoracoscopic bullectomy were randomly divided into eras group and control group.There were 28 cases in eras group without chest tube placement and 32 cases in control group with chest tube placement.The pain scores,postoperative ambulation time,complication rate,postoperative hospital stay and total hospitalization expenses were compared between the two groups.Results The pain scores at 24 h,48 h and 72 h after operation in eras group were significantly lower than those in control group[(2.82±1.13)vs(5.12±1.74),(1.92±0.83)vs(3.93±1.48)and(1.01±0.44)vs(2.03±0.63)],the differences were statistically significant(P<0.05).The postoperative ambulation time of eras group was significantly lower than that of control group[(1.81±0.47)d vs(3.23±1.63)d],the difference was statistically significant(P<0.05).The incidence of postoperative complications in eras group was lower than that in control group[14.3%(4/28)vs 37.5%(12/32)],the difference was statistically significant(P<0.05).The postoperative hospital stay of eras group was lower than that of control group[(4.35±1.42)d vs(6.23±1.76)d],the difference was statistically significant(P<0.05).The hospitalization cost of eras group was lower than that of traditional group[(1.65±0.42)ten thousand yuan vs(1.92±0.57)ten thousand yuan],the difference was statistically significant(P<0.05).Conclusion Carefully selected group of patients undergoing thoracoscopic bullae resection,chest tubelessis feasible and safe,which can accelerate the patient's recovery.

关 键 词：加速康复外科 肺大疱 胸管引流 

分 类 号：R473.6[医药卫生—护理学]