基于加速康复外科的早期下床活动方案在肺癌患者术后康复中的应用效果

Effects of early ambulation program based on enhanced recovery after surgery in postoperative rehabilitation of lung cancer patients

目的探讨基于加速康复外科(ERAS)的早期下床活动方案在肺癌患者术后快速康复中的应用效果。方法采用便利抽样法选取2019年7-12月在同济大学附属上海市肺科医院住院并已行胸腔镜肺叶切除术治疗的160例肺癌患者作为研究对象,最终157例患者完成研究,采用随机数表法将患者分成对照组和观察组,对照组79例,观察组78例。对照组患者采用常规护理模式进行护理,观察组在常规护理基础上给予基于ERAS的早期下床活动方案干预。比较两组患者术后临床恢复指标、疼痛评分及术后并发症发生情况的差异。结果两组患者术后第1天的胸腔引流量比较,差异无统计学意义(P>0.05);观察组第2天胸腔引流量少于对照组,且观察组术后首次下床活动时间、首次排便时间、胸引管留置时间及术后住院时间均短于对照组,差异均有统计学意义(P<0.05)。术后第1天观察组疼痛评分和对照组比较,差异无统计学意义(P>0.05),术后第2天观察组疼痛评分低于对照组,差异有统计学意义(P<0.05)。两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论基于ERAS的早期下床活动方案干预有利于肺癌术后患者临床指标的恢复,缩短住院天数,值得在临床推广。

Objective To explore the effect of early ambulation program based on enhanced recovery after surgery(ERAS)in rapid rehabilitation of lung cancer patients after surgery.Methods From July to December 2019,we selected 160 patients with lung cancer who hospitalized in Shanghai Pulmonary Hospital of Tongji University and underwent thoracoscopic lobectomy by convenience sampling as research objects,and finally 157 patients completed the study.Patients were divided into control group and observation group by random number table method,with 79 cases in control group and 78 cases in observation group.Patients in observation group were treated with routine nursing care,and observation group was given early ambulation program based on ERAS on the basis of routine nursing care.The differences in postoperative clinical recovery indicators,pain scores and postoperative complications were compared between two groups.Results There was no statistically significant difference in the thoracic drainage volume of patients between two groups on the first day after surgery(P>0.05).The thoracic drainage volume of observation group was less than that of control group on the second day,and the time of first ambulation,first defecation time,thoracic drainage tube indwelling time and postoperative hospital stay after surgery of observation group were shorter than those of control group,and the differences were all statistically significant(P<0.05).There was no statistical difference in the incidence of postoperative complications between two groups(P>0.05).Conclusions Early ambulation program based on ERAS is conducive to the recovery of clinical indicators of patients with lung cancer after surgery and shortens the length of hospitalization,which is worthy of clinical promotion.