加速康复外科多环节管理体系在胸腔镜肺切除术病人的应用效果分析  

Application effect of ERAS multi-link management system in patients undergoing thoracoscopic pneumonectomy

作　　者：罗强[1] 黄斯阳[1] 张晓安[1] 马汇斌[1] 黄立文 阳诺[2] LUO Qiang;HUANG Siyang;ZHANG Xiaoan(Department of Thoracic Gland Surgery,Minzu Hospital,Nanning 530001,China)

机构地区：[1]广西壮族自治区民族医院胸心腺体外科,南宁530001 [2]广西医科大学第一附属医院心胸外科

出　　处：《临床外科杂志》2023年第2期168-171,共4页Journal of Clinical Surgery

基　　金：2021年度广西医疗卫生适宜技术开发与推广应用项目(S2021098);2021年度广西高等教育本科教学改革工程项目(2021JGB55)。

摘　　要：目的 探讨加速康复外科(ERAS)多环节管理体系应用于胸腔镜肺切除术病人的临床效果。方法 选取2019年1月~2021年12月我院胸腔镜肺切除术病人302例,分为ERAS组(164例)及对照组(138例),ERAS组应用ERAS多环节管理体系,对照组应用传统的围手术期管理。比较两组病人的一般资料和临床指标。结果 ERAS组和对照组的手术时间分别为(163.7±55.42)分钟和(157.9±53.25)分钟、术中出血量分别为(68.48±52.35)ml和(74.19±51.28)ml、胸管留置时间分别为(2.44±0.65)天和(2.38±0.57)天,住院费用分别为(4.67±0.57)万元和(4.55±0.62)万元,两组比较差异无统计学意义(P>0.05)。ERAS组术后并发症总发生率较对照组低(12.00%和26.09%),但差异无统计学意义(P>0.05)。ERAS组术后不同时间点的NRS疼痛评分均低于对照组,差异有统计学意义(P<0.05);ERAS组和对照组的住院时间分别为(7.55±2.31)天和(8.31±2.43)天,就医满意度评分分别为(8.24±1.68)分和(7.72±1.83)分,两组比较差异有统计学意义(P<0.05)。结论 对于胸腔镜肺切除术病人,应用ERAS多环节管理体系能够加快康复,减轻痛苦。Objective To explore the effect of enhanced recovery after surgery(ERAS) multi-step management system in patients undergoing thoracoscopic pneumonectomy.Methods A total of 302 patients undergoing thoracoscopic pneumonectomy admitted to our hospital from January 2019 to December 2021 were selected as the research objects.They were divided into the ERAS group(164 cases) and the control group(138 cases).The ERAS group applied ERAS multi-step management system, the control group applied traditional perioperative management.The general data and clinical indicators of the two groups were compared.Results There was no significant difference between the ERAS group and the control group in operation time[(163.7±55.42)min vs(157.9±53.25) min],intraoperative blood loss[(68.48±52.35) ml vs(74.19±51.28) ml],surgical method, lesion location, postoperative pathology, chest tube indwelling time[(2.44±0.65) d vs( 2.38±0.57) d] and hospitalization cost[(4.67±0.57) wan yuan vs(4.55±0.62) wan yuan)(P>0.05).The total incidence of postoperative complications in the ERAS group was lower than that in the control group(12.00% vs 26.09%),but the difference was not statistically significant(P<0.05).The NRS pain scores at different time points after operation in ERAS group were lower than those in control group(P<0.05).The hospitalization time of the ERAS group was shorter than that of the control group[(7.55±2.31) d vs(8.31±2.43) d],and the medical satisfaction score was higher[(8.24±1.68) points vs(7.72±1.83)points](P<0.05).Conclusion For patients undergoing thoracoscopic pneumonectomy, the application of ERAS multi-step management system can accelerate the rehabilitation of patients, reduce their pain.

关 键 词：加速康复外科 胸腔镜肺切除术 围手术期 管理 

分 类 号：R473.6[医药卫生—护理学]