快速康复外科在周围型肺癌单孔胸腔镜肺叶切除术患者中的应用

Application of Fast Track Surgery in Patients with Peripheral Lung Cancer Undergoing Single Port Thoracoscopic Lobectomy

【目的】分析快速康复外科(Fast track surgery,FTS)在周围型肺癌单孔胸腔镜肺叶切除术患者中的应用价值。【方法】选取本院2018年1月至2019年12月收治的180例周围型肺癌患者,将其随机分为FTS组(观察组)、常规康复组(对照组),各90例,均行单孔胸腔镜肺叶切除术。对照组接受围术期常规康复干预,观察组接受基于FTS理念的围术期干预,两组干预均持续至出院前1 d。对比两组患者手术情况、术后,恢复情况、并发症发生情况、康复满意度以及术后疼痛视觉模拟评分(VAS)、动脉血氧饱和度(SaO_(2))的变化。【结果】观察组患者手术时间、术后下床时间、术后拔管时间、术后住院时间均低于对照组,差异均有统计学意义(P<0.05);观察组术后并发症发生率低于对照组(5.56%vs 15.56%)、术后康复满意度高于对照组(96.67%vs 78.89%),差异有统计学意义(P<0.05)。观察组患者术后4 h、术后24 h、术后48 h的VAS评分低于对照组;术后2 d患者SaO_(2)高于对照组,差异有统计学意义(P<0.05)。【结论】基于FTS理念开展围术期干预,能够缩短周围型肺癌单孔胸腔镜肺叶切除术患者手术时间、促进术后恢复、提高患者康复满意度、减轻术后疼痛。

【Objective】To explore the application value of fast track surgery(FTS)in patients with peripheral lung cancer undergoing single port thoracoscopic lobectomy.【Methods】A total of 180 patients with peripheral lung cancer in our hospital from January 2018 to December 2019 were randomly divided into the FTS group and the conventional rehabilitation group,with 90 cases in each group.All patients underwent single port thoracoscopic lobectomy.The conventional rehabilitation group received routine rehabilitation intervention during perioperative period,while the FTS group,received perioperative intervention based on FTS concept,the intervention lasted until 1 day before discharge.The operation situation,postoperative recovery,complications,rehabilitation satisfaction,VAS and SaO_(2) were compared between the two groups.【Results】The operation time of FTS group was significantly shorter than that of conventional rehabilitation group(P<0.05).The time of getting out of bed,postoperative extubation and hospital stay in FTS group were significantly lower than those in conventional rehabilitation group(P<0.05).The incidence of postoperative complications in FTS group was 5.56%,which was lower than 15.56% in conventional rehabilitation group(P<0.05).The postoperative rehabilitation satisfaction of FTS group was 96.67%,which was higher than 78.89% of conventional rehabilitation group(P<0.05).The VAS scores of FTS group at 4 h,24 h and 48 h after operation were all lower than those of conventional rehabilitation group(P<0.05).The resting SaO_(2) of FTS group was higher than that of conventional rehabilitation group at 2 days after operation,and the difference was statistically significant(P<0.05).【Conclusion】The perioperative intervention based on FTS concept can shorten the operation time of single port thoracoscopic lobectomy for peripheral lung cancer,promote postop erative recovery,improve patients rehabilitation satisfaction and reduce postoperative pain.