快速康复外科在老年肺癌胸腔镜手术中的应用研究

The application of fast-track surgery in thoracoscopic lung cancer operation for the aged patients

目的:探讨快速康复外科(fast track surgery,FTS)理念在老年肺癌胸腔镜手术中的应用价值。方法:2011年6月至2014年6月对108例胸腔镜手术的老年肺癌患者,采用单盲数表法随机分为FTS组(观察组)与常规治疗组(对照组),每组54例,观察组术后应用FTS理念进行围手术期处理,对照组采用常规术前术后管理。记录两组手术时间、术中出血量、术后下床活动时间、术后胸管拔除时间、术后住院时间、住院费用、术后前3 d VAS评分、胸腔穿刺率及并发症等。结果:两组患者手术时间、术中出血量、术后胸腔穿刺率及术后并发症发生率差异无统计学意义(P>0.05)。但两组患者术后前3 d VAS评分、术后下床活动时间、术后胸管拔除时间、术后住院时间、术后费用差异均有统计学意义(P<0.05)。结论:FTS理念应用于老年肺癌腔镜外科有助于患者术后快速康复,节约社会医疗资源,使老年肺癌患者受益。

Objective： To explore the clinical value of fast track surgery（ FTS） in thoracoscopic lung cancer operation of the aged patients. Methods： One hundred and eight aged patients who suffered from lung cancer,undergoing operation from Jun. 2011 to Jun. 2014,were randomly divided into 2 groups,one as FTS group（ n = 54）,and the other as control group（ n = 54）. The traditional preoperative and postoperative management was used in the control group. Operation time,intraoperative bleeding,the ambulation time after operation,the time of removal chest tubes,the hospitalization days after operation,hospitalization expenses,the VAS score of the first 3 d after surgery,the rate of thoracentesis and complication rate were recorded and counted. Results： Operation time,intraoperative bleeding,the rate of thoracentesis and complication rate between the 2 groups showed no significant difference（ P〉0. 05）. The difference of the VAS score of the first 3 d after surgery,the first ambulation time after operation,the time of removal chest tubes,the hospitalization days after operation and hospitalization expenses between the 2 groups were statistically significant（ P〈0. 05）. Conclusions：The application of FTS in thoracoscopic lung cancer operation of the aged patients not only accelerates the postoperative recovery but also saves the social medical resources. It is beneficial for the aged patients with lung cancer.