快速康复外科理念下单孔胸腔镜肺癌根治术的护理

目的探讨肺癌患者采用快速康复外科（FTS）流程结合单操作孔胸腔镜治疗模式的护理经验。方法对49例肺癌患者实施术前有效的宣教与访视，强化呼吸功能锻炼，术前不常规禁饮，术中的控温、控制补液及微创手术的配合，术后尽旱进食、尽早拔管、有效镇痛及早期下床活动等一系列FTS流程的护理。结果术中出血量平均（70．2±26．3）ml，术后胸管留置时间平均（2．0±0.9）d，术后下床时间平均（20．5±3．2）h，术后住院时间平均（3．9±0．3）d，肺漏气2例，肺不张l例，胸腔积液再置管2例，经积极对症治疗及精心护理，49例患者均康复出院。结论采用FTS流程结合单操作孔胸腔镜治疗模式护理，做到科学搭配、紧密配合、有效落实，有利于缩短住院时间，加快肺癌患者术后康复。

Objective To investigate the nursing of lung cancer patients who undergo fast-track surgery （ FTS ） process combined with single-incision thoracoscopic surgery. Methods 49 patients of lung cancer were educated, respiratory trained and not prohibited to drink preoperatively. The temperature and fluid infusion were controlled during operation, and patients were encouraged to eat and walk off-bed. The drainage tubes were removed early, and analgesic therapy were effectively performed. Results The average bleeding was 70.2 ±26.3 mL during operation; The average drainage tubes remove time was 2.0 ± 0.9 days, average off-bed time was 20.5 ± 3.2 hours, and average hospital-stay was 3.9 ± 0.3 days. Two patients had pulmonary air leakage, one patient had pulmonary atelectasis, and two patients had pleural effusion and underwent chest drainage. All 49 patients had a favorable recovery. Conclusions FTS process combined with single-incision thoracoscopic surgery is advantageous to the postoperative recovery for lung cancer patients.