针对性干预对肺癌手术患者术后肺功能及应激反应的影响  

Effect of targeted intervention on postoperative pulmonary function and stress response in patients receiving lung cancer surgery

作　　者：张繁[1] 朱玉芬[1] 毛冰佳[1] 杨园园[1] ZHANG Fan;ZHU Yufen;MAO Bingjia;YANG Yuanyuan(Department of Respiratory Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,He’nan,China)

机构地区：[1]郑州大学第一附属医院呼吸内科,郑州4500000

出　　处：《癌症进展》2023年第2期202-205,209,共5页Oncology Progress

摘　　要：目的 探讨针对性干预对肺癌手术患者术后肺功能及应激反应的影响。方法 将2019年1月至2020年5月采用围手术期常规干预的49例肺癌患者作为常规组,2020年6月至2022年1月采用围手术期针对性干预的49例肺癌患者作为观察组。比较两组患者术后恢复进程指标、炎性反应指标[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)]、应激反应指标[皮质醇(Cor)、生长激素(GH)、促肾上腺皮质激素(ACTH)、前列腺素E2(PGE2)]、术后并发症发生率、肺功能指标[第1秒用力呼气容积占预计值百分比(FEV1%pred)、用力肺活量占预计值百分比(FVC%pred)、最大通气量占预计值百分比(MVV%pred)]及活动耐力指标[6分钟步行试验(6MWT)]。结果 观察组患者术后咳嗽持续时间、痰液黏稠消失时间、排痰困难消失时间、肺部啰音消失时间、住院时间均明显短于常规组,差异均有统计学意义(P﹤0.01)。术后3天,两组患者血清CRP、PCT、IL-6水平均高于本组术前,但观察组患者血清CRP、PCT、IL-6水平均低于常规组,差异均有统计学意义(P﹤0.05)。术后3天,两组患者血清Cor、GH、PGE2水平均高于本组术前,常规组患者血清ACTH水平高于本组术前,但观察组患者血清Cor、GH、PGE2水平均低于常规组,差异均有统计学意义(P﹤0.05)。观察组患者术后并发症总发生率低于常规组,差异有统计学意义(P﹤0.05)。术后1个月,两组患者FEV1%pred、FVC%pred、MVV%pred、6MWT均低于本组术前,但观察组患者FEV1%pred、FVC%pred、MVV%pred、6MWT均高于常规组,差异均有统计学意义(P﹤0.05)。结论 针对性干预能够促进肺癌手术患者术后恢复,降低肺癌患者术后应激反应程度,进一步改善患者肺功能,增强活动耐力。Objective To investigate the effect of targeted intervention on postoperative pulmonary function and stress response in patients receiving lung cancer surgery. Method A total of 49 lung cancer patients who received routine perioperative intervention from January 2019 to May 2020 were used as the routine group, and 49 lung cancer patients who received targeted intervention during the perioperative period from June 2020 to January 2022 were regarded as the observation group. The postoperative recovery process indicators, inflammatory response indicators [C-reactive protein(CRP), procalcitonin(PCT), interleukin-6(IL-6)], stress response indicators [cortisol(Cor), growth hormone(GH), adrenocorticotropic hormone(ACTH), prostaglandin E2(PGE2)], the postoperative complication rate, pulmonary function index [forced expiratory volume in the first second as a percentage of predicted value(FEV1%pred), forced vital capacity as a percentage of predicted value(FVC%pred), and maximal voluntary ventilation as a percentage of predicted value(MVV%pred)] and activity tolerance index [6 minute walk test(6MWT)] were compared between the two groups.Result The postoperative cough duration, sputum viscosity disappear time, sputum difficulty disappear time, pulmonary rales disappear time, and hospital stay in the observation group were significantly shorter than those in the routine group,and the differences were statistically significant(P<0.01). Three days after the operation, the levels of serum CRP, PCT,and IL-6 in the two groups were higher than those before the operation, but the levels of the above indicators in the observation group were lower than those in the routine group, and the differences were statistically significant(P<0.05). Three days after the operation, the serum levels of Cor, GH, and PGE2in the two groups were higher than those before the operation, and the serum ACTH level in the routine group was higher than that before the operation, however, the serum Cor,GH, and PGE2levels in the observation group were lower t

关 键 词：肺癌 胸腔镜 手术 应激反应 肺功能 针对性干预 

分 类 号：R734.2[医药卫生—肿瘤]