围术期规范化管理在行肺切除术的结核性毁损肺患者中的应用效果  

Application Effect of Perioperative Standardized Management in Patients with Tuberculous Destructive Lung Undergoing Pneumonectomy

作　　者：唐中明 张爱平 李敏珍 黄克峰 刘玮 Tang Zhongming;Zhang Aiping;Li Minzhen;Huang Kefeng;Liu Wei(Department of Thoracic Surgery,Guangxi Zhuang Autonomous Region Chest Hospital,Liuzhou 545005,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西壮族自治区胸科医院胸外科,广西壮族自治区柳州545005

出　　处：《中外医药研究》2023年第32期129-131,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：广西壮族自治区卫生厅自筹经费科研课题(编号:Z2009185)。

摘　　要：目的:探究围术期规范化管理在行肺切除术的结核性毁损肺患者中的应用效果。方法:选取2021年1月—2023年1月广西壮族自治区胸科医院拟行肺切除术治疗的结核性毁损肺患者150例为研究对象,随机分为常规组和规范组,各75例。常规组采用常规围术期管理,规范组采用围术期规范化管理。比较两组术中指标、肺功能指标[最大自主通气量(MVV)、用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、术后并发症发生率、住院时间和病死率。结果:规范组手术时间短于常规组,术中出血量和术中输血量少于常规组,差异有统计学意义(P<0.001);术后3 d,两组MVV、FVC、FEV_(1)、PaO_(2)水平高于术前,PaCO_(2)水平低于术前,规范组MVV、FVC、FEV_(1)、PaO_(2)水平高于常规组,PaCO_(2)水平低于常规组,差异有统计学意义(P<0.05);规范组术后并发症发生率、病死率低于常规组,住院时间短于常规组,差异有统计学意义(P<0.05)。结论:规范化围术期管理可提高结核性毁损肺患者行肺切除术的安全性和预后效果,值得临床推广。Objective:To investigate the application effect of perioperative standardized management in patients with tuberculous destructive lung who underwent pneumonectomy.Methods:One hundred and fifty cases of patients with tuberculous destructive lungs to be treated with pneumonectomy in the Guangxi Zhuang Autonomous Region Chest Hospital from January 2021 to January 2023 were selected as the study subjects,and randomly divided into the conventional group and the standardized group,seventyfive cases each.The conventional group adopted conventional perioperative management,and the standardized group adopted perioperative standardized management.Intraoperative indexes,pulmonary function indexes[maximum voluntary ventilation(MVV),forced vital capacity(FVC),forced expiratory volume in the first second(FEV_(1))],blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],incidence of postoperative complications,length of hospitalization and morbidity and mortality rates were compared between the two groups.Results:The operation time of the standardized group was shorter than that of the conventional group,and the intraoperative bleeding and intraoperative blood transfusion were less than those of the conventional group,with statistically significant differences(P<0.001);3 days after surgery,the levels of MVV,FVC,FEV_(1)and PaO_(2)were higher than before surgery and PaCO_(2)level was lower than before surgery in both groups,and the levels of MVV,FVC,FEV_(1)and PaO_(2)were higher in the standardized group than in the conventional group,and the level of PaCO_(2)was lower than in the conventional group,with a statistically significant difference(P<0.05);the incidence of postoperative complications and morbidity and mortality rates in the standardized group were lower than those in the conventional group,and the hospitalization time was shorter than that in the conventional group,with statistically significant differences(P<0.05).Conclusion:Standardized perioperative manag

关 键 词：结核性损毁肺 肺切除手术 围术期 规范化管理 

分 类 号：R47[医药卫生—护理学]