中医特色快速康复外科在老年肺癌胸腔镜根治术患者中的应用  

Application of Rapid Rehabilitation Surgery with Chinese characteristics in Elderly Patients with Lung Cancer Undergoing Thoracoscopic Radical Surgery

作　　者：林舜艳[1] 尹正录[1] 孙超[1] 陈波[1] 高伟 LIN Shunyan;YIN Zhenglu;SUN Chao;CHEN Bo;GAO Wei(School of Clinical Medicine of Yangzhou University(Jiangsu Subei People's Hospital),Jiangsu Yangzhou 225001,China)

机构地区：[1]扬州大学临床医学院/江苏省苏北人民医院,江苏扬州225001

出　　处：《现代中医药》2023年第1期110-115,共6页Modern Chinese Medicine

基　　金：江苏省青年医学重点人才项目(QNRC2016336);扬州市医学重点人才项目(201847)。

摘　　要：目的构建中医特色快速康复外科(Enhanced Recovery After Surgery,ERAS)并评价其在老年肺癌胸腔镜根治术患者中的安全性和有效性。方法前瞻性选择2018年1月1日—2020年12月31日期间在苏北人民医院行胸腔镜根治术的老年肺癌患者,采用随机数字表法分为对照组和治疗组。对照组患者围手术期接受ERAS治疗,治疗组接受中医特色ERAS的治疗。比较两组患者术后并发症、术前及术后3 d肺功能及外周血清白细胞介素-1β(IL-1β)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平。结果本研究共有70名符合纳入标准的肺癌患者,最终有67名患者完成研究,对照组(n=23)和治疗组(n=34)。对照组拔管时间、下床活动时间及住院时间分别为:(5.31±1.17)、(3.14±1.02)和(8.69±1.37)天;治疗组分别为:(3.12±1.11)、(2.08±0.75)和(6.57±1.25)天,治疗组各项指标优于对照组,差异有统计学意义(P<0.05)。对照组共有11例发生并发症(33.3%),治疗组共有6例(17.6%),治疗组发生率低于对照组,差异有统计学意义(P<0.05)。两组患者出院前1天肺功能指标较前下降,有统计学意义(P<0.05),组间比较,治疗组优于对照组,差异有统计学意义(P<0.05)。两组患者术后3天各项指标较前增高,差异均有统计学意义(P<0.05),组间比较,治疗组各项指标低于对照组,差异均有统计学意义(P<0.05)。结论中医特色ERAS体系可以减少老年肺癌患者胸腔镜根治术后并发症,有利于肺功能恢复,并抑制早期炎症因子的释放。Objective To construct a rapid rehabilitation surgery with Chinese characteristics(ERAS)and evaluate its safety and effectiveness in elderly patients with lung cancer undergoing thoracoscopic radical surgery.Methods From January 1,2018 to December 31,2020,the elderly patients with lung cancer who underwent thoracoscopic radical surgery in Subei People’s Hospital were prospectively selected and divided into the control group and the treatment group by random number table.The patients in the control group received ERAS treatment during the perioperative period,and the patients in the treatment group received ERAS treatment with Chinese characteristics.Postoperative complications,pulmonary function before and 3 days after operation and peripheral serum interleukin-1β(IL-1β),Interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)were compared between the two groups.Results A total of 70 lung cancer patients met the inclusion criteria in this study,and 67 patients completed the study,including the control group(n=23)and the treatment group(n=34).The extubation time,ambulation time and hospitalization time of the control group were(5.31±1.17),(3.14±1.02)and(8.69±1.37)days,respectively;The treatment group was(3.12±1.11),(2.08±0.75)and(6.57±1.25)days,respectively.The indexes in the treatment group were better than those in the control group,with a statistically significant difference(P<0.05).There were 11 cases of complications in the control group(33.3%),and 6 cases in the treatment group(17.6%).The incidence in the treatment group was lower than that in the control group,with a statistically significant difference(P<0.05).The pulmonary function indexes of the two groups decreased one day before discharge,with statistical significance(P<0.05).Compared with the control group,the treatment group was superior to the control group,with statistical significance(P<0.05).Three days after operation,all indexes of the two groups were higher than before,and the difference was statistically significant(P<0.05).Compared be

关 键 词：中医 快速康复外科 肺癌 胸腔镜 肺功能 炎性细胞因子 

分 类 号：R273[医药卫生—中西医结合]