摘要
目的探讨解剖性肺段切除术(anatomic partial lobectomy,APL)在早期肺癌中的应用及加速康复外科理念(accelerated rehabilitation philosophy,ERAS)优化围术期管理流程的效果。方法选取2019年12月1日至2022年12月31日泰安市中心医院胸外科622例早期肺癌手术患者的完整临床资料,通过随机数字法分为试验组和对照组。两组患者均接受APL,试验组311例患者在围术期予以ERAS管理,对照组311例患者予以常规管理。选取性别、年龄、吸烟史、术后住院天数、肺功能等指标记录并比较。结果与对照组相比,试验组排气时间短、住院时间短、术后肺功能恢复快,差异均有统计学意义(P<0.05),术中出血量比较差异无统计学意义(P>0.05)。术后5 d每日评估疼痛评分中,术后7 h、第1天疼痛评分比较差异无统计学意义(P>0.05),术后第2天至第5天的疼痛评分两组差异具有统计学意义(P<0.05)。试验组患者术后肺功能指标优于对照组,差异具有统计学意义(P<0.05)。试验组患者术后并发症发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论APL-ERAS这一综合模式在早期肺癌的外科治疗中能够加速患者术后康复,包括缩短术后住院日,改善术后呼吸功能,降低术后并发症发生率。
Objective:To investigate the application of anatomic partial lobectomy(APL)in early stage lung cancer and to evaluate the effect of accelerated rehabilitation philosophy(ERAS)in optimizing perioperative management procedures.Methods:The complete clinical data of 622 patients with early stage lung cancer in thoracic surgery department of our hospital from December 1,2019 to December 31,2022 were selected and divided into two groups,experimental and control group rondomly.Patients in both groups underwent anatomical segmental lung resection,and 311 patients in the experimental group were managed with ERAS during the perioperative period,while 311 patients in the control group were managed conventionally.Age,sex,smoking history,postoperative hospital stay,postoperative lung function and other indicators were recorded for comparison.Results:Compared with the control group,the experimental group had longer operation time,less drainage volume,shorter hospital stays and faster recovery of postoperative lung function,and the differences between the two groups were statistically significant(P<0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).There was no significant difference in pain score(NRS)at 6 hours and 1 day after surgery between the two groups(P>0.05).NRS score of the experimental group was significantly lower than that of the control group at 2 to 5 days after surgery,the difference was statistically significant(P<0.05).Postoperative lung function indexes of experimental group were higher than those of control group,and the difference was statistically significant(P<0.05).The postoperative complications in the experimental group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusions:APL-ERAS can improve postoperative respiratory function,reduce postoperative complications,shorten hospital stay and accelerate recovery in patients with early lung cancer.
作者
孔凡华
谢博恒
宗翔
张艳
康士佳
亓琴
KONG Fanhua;XIE Boheng;ZONG Xiang;ZHANG Yan;KANG Shijia;QI Qin(Departments of Thoracic Surgery,Taian Centeral Hospita,Taian 271000,China)
出处
《山东第一医科大学（山东省医学科学院）学报》
CAS
2023年第11期835-839,共5页
Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences
关键词
解剖性肺段切除术
早期肺癌
加速康复外科理念
围术期管理流程
anatomic partial lobectomy
early lung cancer
accelerated rehabilitation philosophy
perioperative management process
