中医药联合快速康复外科在胸外科围手术期患者的临床应用研究  

Study on the clinical application of traditional Chinese medicine therapy combined with enhanced recovery after surgery in the perioperative period of thoracic surgery

作　　者：韩朝辉 马虹宇[2] 薛文飞 张霄鹏[1] 胡仲辉 段国辰 HAN Zhaohui;Ma Hongyu;Xue Wenfei;Zhang Xiaopeng;Hu Zhonghui;DUAN Guochen(Department of Thoracic Surgery,Hebei General Hospital,Shijiazhuang,Hebei 050051;Department of Traditional Chinese Medicine,Hebei General Hospital,Shijiazhuang,Hebei 050051;Department of Thoracic Surgery,Hebei Children’s Hospital,Shijiazhuang,Hebei 050031)

机构地区：[1]河北省人民医院胸外科,河北石家庄050051 [2]河北省人民医院中医科,河北石家庄050051 [3]河北省儿童医院胸外科,河北石家庄050031

出　　处：《河北中医》2023年第7期1114-1119,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2019年度中医药类科研计划课题(编号:2019139)。

摘　　要：目的观察中医药联合快速康复外科(ERAS)在胸外科围手术期患者中的应用效果。方法选取2019年6月至2019年12月河北省人民医院胸外科围手术期住院患者80例,按照随机数字表法分为2组,对照组40例予常规ERAS手段治疗,治疗组40例在对照组基础上联合中医药治疗(针刺疗法联合中药口服)。观察比较2组术后首次排气时间、首次排便时间、首次摄入固体食物时间、首次离床活动时间、胸腔引流量及引流管拔除时间情况,比较2组术后疼痛、恶心呕吐、腹胀、乏力症状评分变化情况,比较2组住院时间、住院费用及住院满意度评分情况,比较2组术后并发症肺不张、下肢深静脉血栓形成、气胸的发生情况。结果2组术后首次排气时间、首次排便时间、首次摄入固体食物时间比较差异均有统计学意义(P<0.05),治疗组所需时间均短于对照组,但2组首次离床活动时间、胸腔引流量及引流管拔除时间比较差异无统计学意义(P>0.05)。2组术后疼痛、恶心呕吐、腹胀及乏力症状评分比较差异均有统计学意义(P<0.05),治疗组各项评分均低于对照组。2组住院时间及住院满意度评分情况比较差异均有统计学意义(P<0.05),治疗组住院时间短于对照组,住院满意度评分高于对照组,但2组住院费用比较差异无统计学意义(P>0.05)。治疗组术后并发症总发生率2.5%(1/40),对照组术后并发症总发生率15.0%(6/40),治疗组术后并发症总发生率低于对照组(P<0.05)。结论中医药联合ERAS在胸外科围手术期患者的应用中优势明显,可以有效促进患者术后康复,减轻术后症状,预防术后并发症的发生,同时具有良好的安全性,并获得了患者的广泛认可。Objective To explore the application effect of Traditional Chinese Medicine(TCM)therapy combined with enhanced recovery after surgery(ERAS)mode in perioperative patients of thoracic surgery.Methods A total of 80 patients who underwent surgical treatment in the Department of Thoracic Surgery of Hebei General Hospital from June 2019 to December 2019 were selected,and randomly allocted to the control group(n=40)and the treatment group(n=40).On the basis of ERAS treatment,the patients of the treatment group were additionally treated with oral TCM.Between the two groups,the first exhaust,first defecation,first solid food intake,first ambulation,thoracic drainage volume,and drainage tube removal time were recored;the changes of postoperative pain,nausea and vomiting,abdominal distension and fatigue symptom scores were compared;the hospitalization time,hospitalization expenses and hospitalization satisfaction scores were compared;and the incidence of postoperative complications(atelectasis,lower extremity deep vein thrombosis and pneumothorax)was counted.Results The time to first exhaust,first defecation,and first solid food intake in the treatment group was significantly shorter than that in the control group(P<0.05).There was no significant difference in the time to first ambulation,thoracic drainage volume,and drainage tube removal time(P>0.05).The scores of pain,nausea and vomiting,abdominal distension and fatigue symptoms in the treatment group were significantly lower than those in the control group(P<0.05).The hospitalization time in the treatment group was significantly shorter than that in the control group(P<0.05),and the hospitalization satisfaction score was significantly higher than that in the control group(P<0.05),but the hospitalization expenses were comparable between groups(P>0.05).The incidence of postoperative complications in the treatment group was lower than that in the control group(2.5%[1/40]vs 15.0%[6/40],P<0.05).Conclusion For thoracic surgery patients,TCM therapy combined with ERAS mode has o

关 键 词：胸外科 围手术期 快速康复外科 中医疗法 

分 类 号：R289.6[医药卫生—方剂学]