基于前馈控制的加速外科康复理念在胸腔镜下肺切除术后麻醉复苏期的应用效果

Application effect of the concept of accelerated surgical rehabilitation based on feedforward control in the period of anesthesia and resuscitation after thoracoscopy pneumonectomy

目的 探讨基于前馈控制的加速外科康复理念在胸腔镜下肺切除术后麻醉复苏期中的应用效果。方法 选择安徽省马鞍山市人民医院2020年7月至2022年12月拟行胸腔镜下肺切除术106例患者作为研究对象,采用随机数字表法将患者分为常规组与试验组,各53例。常规组采用常规护理,试验组采用基于前馈控制的加速外科康复理念干预。比较两组进入麻醉复苏室(T_(1))、进入麻醉复苏室10 min(T_(2))、出麻醉复苏室(T_(3))时镇静、躁动程度[镇静-躁动评分量表(SAS)]、术后并发症、不良事件发生率、麻醉复苏室停留时间、舒芬太尼使用量。结果 整体分析发现,两组SAS评分组间、时点比较及交互作用差异有统计学意义(P<0.05)。进一步两两比较,组内比较:常规组T_(1)、T_(2)、T_(3)比较,试验组T_(1)、T_(2)比较,差异有统计学意义(P<0.05);组间比较:试验组T_(2)时SAS评分低于常规组,差异有统计学意义(P<0.05)。试验组并发症、不良事件发生率低于常规组,差异有统计学意义(P<0.05)。试验组麻醉复苏室停留时间短于常规组,差异有统计学意义(P<0.05);两组舒芬太尼使用量比较,差异无统计学意义(P>0.05)。结论 基于前馈控制的加速外科康复理念护理在胸腔镜下肺切除术后麻醉复苏期具有良好应用效果。

Objective To explore the application effect of the concept of accelerated surgical rehabilitation based on feedforward control in the period of anesthesia and resuscitation after thoracoscopy pneumonectomy.Methods A total of 106 patients who were to undergo thoracoscopic pulmonary resection from July 2020 to December 2022 in Maanshan People’s Hospital,Anhui Province were selected as the study objects.The patients were divided into conventional group and experimental group by random number method,with 53 cases in each group.The conventional group received routine care,while the experimental group received intervention based on the concept of accelerated surgical rehabilitation using feedforward control.The degree of sedation and agitation(sedation-agitation scale[SAS]),postoperative complications,incidence of adverse events,residence time in anesthesia recovery room and sufentanil dosage were compared between the two groups when entering the anesthesia recovery room(T_(1)),entering the anesthesia recovery room for 10 min(T_(2)),and leaving the anesthesia recovery room(T_(3)).Results The overall analysis of the results showed that there were statistical significant differences in SAS scores between groups,time point comparisons,and their interactions(P<0.05).Further pairwise comparison,intra-group comparison:T_(1),T_(2),and T_(3) were compared in the conventional group,T_(1) and T_(2) was compared in experimental groups,the differences were statistically significant(P<0.05).Inter-group comparison:the SAS score of the experimental group at T_(2) was lower than that of the conventional group,and the difference was statistically significant(P<0.05).The incidence of complications and adverse events in experimental group were lower than those in conventional group,the differences were statistically significant(P<0.05).The stay time in the anesthesia resuscitation room of the experimental group was shorter than that of the conventional group,and the difference was statistically significant(P<0.05).There was no significant difference in the amount of Sufentanil used between the two groups(P>0.05).Conclusion The concept of accelerated surgical rehabilitation nursing based on feedforward control has a good application effect in the period of anesthesia and resuscitation after thoracoscopy pneumonectomy.