加速康复外科理念在单孔胸腔镜手术中的应用效果

Application of enhanced recovery after surgery in singleport video-assisted thoracoscopic surgery

目的探讨加速康复外科(ERAS)理念在单孔胸腔镜手术(VATS)中的应用效果。方法选取2019年11月至2020年11月于本院进行VATS治疗的98例肺癌患者作为研究对象,采用随机数字表法分为对照组和研究组,各49例。两组均进行VATS,对照组围术期采用常规护理,研究组围术期采用ERAS护理。比较两组手术情况、炎症因子水平、术后恢复情况及并发症发生率。结果研究组手术补液量少于对照组(P<0.05);术后1、4、7 d,研究组C反应蛋白(CRP)低于对照组;术后1、4 d,研究组白细胞计数(WBC)低于对照组(P<0.05);研究组术后胸管拔除时间、肠鸣音恢复时间、下床活动时间均短于对照组(P<0.05);术后1、2、3 d,研究组视觉模拟评分法(VAS)评分低于对照组(P<0.05);研究组并发症总发生率为12.24%,低于对照组的30.61%(P<0.05)。结论ERAS在VATS中的应用效果显著,能减轻手术的创伤,降低患者炎症因子水平,促进术后康复,减少并发症的发生,值得临床推广应用。

Objective To explore the application of enhanced recovery after surgery(ERAS)in single-port video-assisted thoracoscopic surgery(VATS).Methods 98 patients with lung cancer who were treated with VATS from November 2019 to November 2020 in our hospital were selected as the research subjects,and they were divided into control group and study group using random number table method,with 49 cases in each group.The control group used routine nursing care during the perioperative period,and the study group used ERAS nursing care during the perioperative period.The operation status,inflammatory factor levels,postoperative recovery,and complication rate between the two groups were compared.Results The amount of surgical fluid in the study group was less than that of the control group(P<0.05).The C-reactionprotein(CRP)of the study group was lower than that of the control group at 1,4,and 7 d after operation,and the white blood cell count(WBC)of study group was lower than that of the control group at 1 and 4 d after operation(P<0.05).The postoperative chest tube removal time,bowel sound recovery time,and time to get out of bed in the study group were shorter than those in the control group(P<0.05).1,2 and 3 d after the operation,the visual analogue scale(VAS)score of the study group was lower than that of the control group(P<0.05).The total incidence of complications in the study group was 12.24%,which was lower than 30.61%of the control group(P<0.05).Conclusion The application of ERAS in VATS is effective,it can reduce the trauma of surgery,reduce the level of inflammatory factors,promote the recovery of patients after surgery,and reduce the occurrence of complications,it is worthy of application.