快速康复外科理念在肺癌围手术期的干预研究

Interventional effect of fast track surgery concept on lung cancer patients during perioperative period

目的探讨快速康复外科(FTS)理念在肺癌外科术中的可行性及安全性。方法随机选取需要手术的肺癌患者100例为研究对象,随机分为研究组、对照组,每组50例。研究组围术期应用FTS理念,对照组采用传统治疗模式。比较两组术后感染等并发症发生率、术后住院时间、留置胸管时间、疼痛VAS评分。比较两组术前,术后1、3、5天血清C-反应蛋白(CRP)水平。结果研究组术后感染类并发症(肺部感染、切口感染)发生率明显低于对照组,差异有统计学意义(P<0.05);术后并发症总发生率明显低于对照组,差异有统计学意义(P<0.01)。两组术后各时间点血清CRP水平均明显高于术前,差异有统计学意义(P<0.01);研究组术后第1、3、5天血清CRP水平明显低于对照组,差异有统计学意义(P<0.01)。研究组术后住院时间、胸管引流时间明显短于对照组,差异有统计学意义(P<0.01);术后各时间点疼痛VAS评分均明显低于对照组,差异有统计学意义(P<0.01)。结论肺癌外科围术期应用FTS理念能够明显降低术后感染等并发症发生率,减少住院时间,减轻患者疼痛,提高患者康复速度。

OBJECTIVE To explore the feasibility and safety of fast track surgery（FTS）concept in the lung cancer surgery.METHODS A total of 100 lung cancer patients who were supposed to received surgical procedures were recruited as the study objects and randomly divided into the study group and the control group,with 50 cases in each group.The study group was treated with FTS concept during the perioperative period,while the control group was treated with conventional treatment mode.The incidence rates of complications such as postoperative infection,postoperative length of hospital stay,chest tube indwelling time and visual analogue scale（VAS）were observed and compared between the two groups of patients.The levels of serum C-reactive protein（CRP）were compared before the surgery and after the surgery for 1,3 and 5 days.RESULTS The incidence rates of postoperative infectious complications（pulmonary infection,incision infection）of the study group were significantly lower than those of the control group（P〈0.05）;the total incidence of postoperative complications of the study group was significantly lower than that of the control group（P〈0.01）.The serum PCT levels of the two groups of patients were significantly higher after the surgery for different time periods than before the surgery（P〈0.01）.The serum CRP levels of the study group were significantly lower than those of the control group after the surgery for1,3 and 5 days（P〈0.01）.The postoperative length of hospital stay and chest tube indwelling time were significantly shorter in the study group than in the control group（P〈0.01）.The VAS scores of the study group were significantly lower than those of the control group after the surgery for different time periods（P〈0.01）.CONCLUSIONS FTS concept may significantly reduce the incidence of postoperative complications such as infections in the lung cancer patients during perioperative period,shorten the length of hospital stay,alleviate the pain and promote the rehabilitation of the patients.