Impact of continuous care on cardiac function in patients with lung cancer complicated by coronary heart disease

BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly commonplace for patients to experience the simultaneous occurrence of cancer and CHD,a trend that is steadily rising.AIM To determine the impacts of continuing care on lung cancer patients with CHD following percutaneous coronary intervention(PCI).METHODS There were 94 lung cancer patients with CHD following PCI who were randomly assigned to the intervention group(n=38)and the control group(n=41).In the intervention group,continuing care was provided,while in the control group,routine care was provided.An evaluation of cardiac and pulmonary function,medication compliance,a 6-min walk test,and patient quality of life was performed.RESULTS Differences between the two groups were significant in left ventricular ejection fraction,6-min walk test,oxygen uptake,quality of life and medication compliance(P<0.05).In comparison with the control group,the enhancement in the intervention group was more significant.The intervention group had more patients with high medication compliance than the control group,with a statistically significant difference(P<0.05).CONCLUSION After undergoing PCI,lung patients with CHD could benefit from continued care in terms of cardiac and pulmonary function,medications compliance,and quality of life.

Role of Ultrasound Lung Comets in the Diagnosis of Acute Heart Failure in Emergency Department: A Systematic Review and Meta-analysis

Objective A new technique of transthoracic lung ultrasonography(TLS) has emerged and demonstrated promising results in acute heart failure diagnosis at an early stage. However, the diagnostic value of ultrasound lung comets(ULCs) for acute heart failure(AHF) performed in busy emergency department(ED) is uncertain. The present meta-analysis aimed to assess the diagnostic efficiency of ULCs in AHF. Methods We conducted a search on online journal databases to collect the data on TLS performed for diagnosing AHF published up to the end of July 2017. The sensitivity, specificity, positive likelihood ratio(PLR), negative likelihood ratio(NLR), and summary receiver operating characteristic(SROC) curve were calculated. The post-test probability of AHF was calculated by using Bayes analysis. Results We enrolled a total of 15 studies involving 3,309 patients. The value of sensitivity, specificity, PLR, NLR, DOR, area under the SROC curve, and Q* index was 85%, 91%, 8.94, 0.14, 67.24, 0.9587, and 0.9026, respectively. We detected significant heterogeneity among included studies, and therefore, all these results were analyzed under the random-effect model. We also explored possible sources of heterogeneity among the studies by using meta-regression analysis. Results suggest that the time interval between patient’s admission to bedside TLS examination was closely related to TLS accuracy. Conclusion This meta-analysis demonstrated that detecting ULCs is a convenient bedside tool and has high accuracy for early AHF diagnosis in ED. TLS could be recommended to be applied for early diagnosis of AHF in ED.

Effectiveness of chest radiography,lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure

Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of hydrostatic pulmonary edema is usuallybased on clinical signs associated to conventional ra-diography findings. Interpretation of radiologic signsof cardiogenic pulmonary edema are often question-able and subject. For a bedside prompt evaluation,lung ultrasound(LUS) may assess pulmonary conges-tion through the evaluation of vertical reverberationartifacts, known as B-lines. These artifacts are relatedto multiple minimal acoustic interfaces between smallwater-rich structures and alveolar air, as it happens incase of thickened interlobular septa due to increase of extravascular lung water. The number, diffusion and in-tensity of B lines correlates with both the radiologic andinvasive estimate of extravascular lung water. The inte-gration of conventional chest radiograph with LUS canbe very helpful to obtain the correct diagnosis. Com-puted tomography(CT) is of limited use in the work upof cardiogenic pulmonary edema, due to its high cost,little use in the emergencies and radiation exposure.However, a deep knowledge of CT signs of pulmonaryedema is crucial when other similar pulmonary condi-tions may occasionally be in the differential diagnosis.

Non-invasive home lung impedance monitoring in early post-acute heart failure discharge: Three case reports

BACKGROUND Patients discharged after hospitalization for acute heart failure(AHF) are frequently readmitted due to an incomplete decongestion, which is difficult to assess clinically. Recently, it has been shown that the use of a highly sensitive,non-invasive device measuring lung impedance(LI) reduces hospitalizations for heart failure(HF); it has also been shown that this device reduces the cardiovascular and all-cause mortality of stable HF patients when used in longterm out-patient follow-ups. The aim of these case series is to demonstrate the potential additive role of non-invasive home LI monitoring in the early postdischarge period.CASE SUMMARY We present a case series of three patients who had performed daily LI measurements at home using the edema guard monitor(EGM) during 30 d after an episode of AHF. All patients had a history of chronic ischemic HF with a reduced ejection fraction and were hospitalized for 6–17 d. LI measurements were successfully made at home by patients with the help of their caregivers. The patients were carefully followed up by HF specialists who reacted to the values of LI measurements, blood pressure, heart rate and clinical symptoms. LI reduction was a more frequent trigger to medication adjustments compared to changes in symptoms or vital signs. Besides, LI dynamics closely tracked the use and dose of diuretics.CONCLUSION Our case series suggests non-invasive home LI monitoring with EGM to be a reliable and potentially useful tool for the early detection of congestion or dehydration and thus for the further successful stabilization of a HF patient after a worsening episode.

Markers of Heart, Lung and Dorsal Aorta Damage of Mother Rats and Their Neonates Post Therapeutic Treatment with Doxorubicin, Cisplatin and 5-Flurouracil

Aim: Recently, there is an increased average of developing cancers. Though, the chemotherapeutic-treatment is unfavorable during pregnancy due to its harmful effects on developing fetuses, physicians have two ways to minimize these effects either by termination of the pregnancy or minimizing its side effects. The present work aimed to illustrate the susceptibility of cardiac, lung and dorsal aorta function to the widely applicable drugs doxorubicin and cisplatin as well as 5-flurouracil. Materials and Methods: Mother albino rats were arranged into four-groups (control, doxorubicin, cisplatin and 5-flurouracil-treated groups). Each pregnant rat received intraperitoneal administration of 0.2 mg/kg body weight at 10th and 14th day of gestation and sacrificed at parturition (two doses). At parturition, serum of mother rats used to assess troponin I, heat shock protein 70, 8-hydroxydeoxyguanosine, vascular endothelial growth factor and adhesion molecules (ICAM-1 & VCAM-1). Isoenzyme electrophoresis of alkaline and acid phosphatases, glucose-6-phosphate dehydrogenase and lactic dehydrogenase were estimated in serum, myocardium and dorsal aorta of mother rats. The myocardium and lung were processed for histopathological investigations for both mothers and their offspring. Single strand (comet assay) and double strand DNA damage were carried out in heart and dorsal aorta of mother rats. Results: The present finding revealed that there are detected alterations of myocardial markers and lung amino acid metabolism as well as disruption of myocardial isoenzymes. DNA damage of myocardium and dorsal aorta were observed. Conclusions: The authors concluded that the metabolic activity of heart and lung is highly susceptible to doxorubicin and cisplatin treatment compared to 5-flurouracil and the therapeutic doses must be degraded.

INVASION OF SPHEROID OF MURINE LUNG ADENOCARCINOMA (LA_(795)) CELLS INTO EMBRYONIC CHICK HEART FRAGMENTS

An in vitro spheriod invasion model of tumor cell was established by using murine lung adenocarcinoma cell line (LA795) and precultured embryonic chick heart fragment (PHF). The spheroid of LA795 cells were prepared by incubating a suspension of trypsinized LA795 cells on a gyratory shaker. Spheroid aggregates of LA795 cells in diameter of 0. 2 mm were selected and confronted with PHF (diameter of 0. 4 mm) on semi- solid medium for 3 - 4 hours, then, individual confronting pain were transferred into fluid medium for further co-culture on gyratory shaker. After 1, 3, 5 and 7 days, multiple confronting pairs were processed for histological and ultrastructural study. The Invasive capacity and the invasion process of LA795 cells were examined and observed. The results demonstrated that LA795 cell line has a high capacity of invasion and high malignancy in vitro. This spheroid Invasion model is very useful for studying mechanism of Invasiveness of tumor cells in vitro.

EXTRAVASCULAR LUNG WATER AND VENTILATORY MANAGEMENT IN CHILDREN AFTER OPEN HEART SURGERY

The accumulation of extravascular lung water （EVLW） after cardiac surgery of congenital heart disease may predicted from the preoperative level of pulmonary blood flow. This accumulation of EVLW may adversely affect ventilatory parameters. Lung compliance （LC）, cardiac index （CI）, blood arterial oxygen tension （PaO2）, left atrial pressure （LAP）and EVLW were measured serially immediately postoperative in two groups of children after complete repair of congenital heart disease contrasted by their level of pulmonary blood flow: Tetralogy of Fallot （TOF, n=10, 4.6±1.9 years） and ventrvcular septal defect with pulmonary arterial hypertension （VSD+PAH, n=10, 5.4±2.0 years）.Using a double indicator-dilution technique （DIDT） the EVLW peaked at the 16th hour postoperation in TOF group and at the 8 th hour postoperation inthe VSD with PAH group. During the first 24 hours after surgery the EVLW was consistently higher in the VSD with PAH group （P【0.01）. There was a negative correlation between the EVLW and LC, CI and PaO2 and no correlation between the EVLW and LAP. In three hypoxemic patients of the VSD with PAH group the LC deteriorated while the EVLW was elevated. After treatment with positive end expiratory pressure （PEEP） the hypoxemia corrected as the LC increased and the EVLW decreased, with no change in the CI. Thus, measurement of EVLW provides a sensitive method for explaining changes in LC, that may lead to a more rational adjustment of mechanical ventilator parameters.

The blossom of “the rose of surgery”——The birth of heart-lung machine

The development of the heart-lung machine made repair of intracardiac lesions possible. One of the key requirements of the heart-lung machine was anticoagulation. Heparin was discovered by a medical student, Jay McLean, working in the laboratory of Dr. William Howell at Johns Hopkins. John Gibbon contributed more to the successful development of the heart-lung machine than anyone else. His interest began as a young doctor since 1930s. Gibbon＇s work on the heart-lung machine took place over the next 20 years in laboratories at Massachusetts General Hospital, the University of Pennsylvania, and Thomas Jefferson University In 1937, he reported the first successful demonstration that life could be maintained by an artificial heart and lung, and the native heart and lungs could resume fimction. After World War II, Dr. Gibbon resumed his work and received support from IBM to build a heart-lung machine on a more sophisticated scale. Eventually, the team developed a larger oxygenator that the IBM engineers incorporated into a new machine. On May 6, 1953, Dr. Gibbon performed the first successful operation using an extracorporeal circuit on an 18-year-old girl with a large atrial septal defect. It wasn＇t until 1958, when a system that involved bubbling blood was perfected, that ＂heart-lung＂ machines came of age. Despite so many chill winds and cold rains, ＂heart-lung＂ machine, the budding rose of surgery, was eventually blossom brightly in the radiant rays of sunlight. John Gibbon＇s dream had become a reality. His work serves as an important example to surgeons who are struggling today with the surgical therapies and technologies of tomorrow.

Discussion on the Prevention and Treatment of COVID-19 Causing Lung Disease and Heart Damage Based on Lei Zhongyi's Theory of Intermingled Phlegm,Blood Stasis and Toxin

Novel coronavirus infection not only damages lung function,but also causes myocardial injury,elevated myocardial enzymes and heart failure,especially for patients with basic heart diseases who develop COVID-19,the first consideration should be the protection of cardiac function.Based on the theory of intermingled phlegm,blood stasis and toxin of heart disease put forward by Master Lei Zhongyi,the dialectical treatment thinking of COVID-19 patients from the concept of damage of phlegm,blood stasis and toxin to the heart were discussed.During the diagnosis,critical stage and recovery period of COVID-19,expectorant and blood-activating agents,heat and detoxification agents can be added to promote lung and asthma,free Bizheng and remove blood stasis,calm the heart and calm the mind,and promote the recovery of cardiopulmonary functions.

Preservation of donor's heart and lung and discrimination and postoperative immunotherapy of graft rejection:a report of 2 cases of heart-lung transplantation

Objective To summarize preservation measures of donor’s heart and lung,and postoperative imrnunotherapy,as well as clinical experience of discrimination and management for graft rejection. Methods Clinical data of 2 cases of heart - lung transplantation in our depart-

FACE-HF: Focused Assessment by Chest Sonography and Echocardiography in Acute Heart Failure Patients

Background: Acute heart failure (AHF) is a life-threatening condition that necessitates urgent evaluation and treatment with an urgent need for hospital admission. Among the available imaging modalities, echocardiography is the method of choice due to its feasibility and cost-effectiveness. Lung ultrasonography in emergency department, critical and cardiac care units is becoming popular. The present study aimed to assess the value of the focused echocardiography and lung ultrasound protocol for guiding treatment and its effect on the hospitalization period in AHF patients admitted to the CCU, 6 months re-hospitalization and mortality. Methods: This study included 40 consecutive patients admitted to the Cardiology and Angiology department after disposition from the emergency department at Alexandria main university hospital in Egypt with the diagnosis of (AHF). Patients were divided into 2 groups, 20 patients received the standard treatment while the other group received a modification of medication doses according to daily imaging changes. All patients were followed up for 6 months to assess the 6 months HF rehospitalization and death rates. Results: Group II patients had a significantly shorter duration of hospitalization;6.45 ± 2.01 days compared to 9.10 ± 3.82 days among group I patients (P = 0.02). There was no significant difference between the two groups regarding the 6 months rehospitalization and death rates. Conclusion: The focused echocardiography and lung ultrasound-guided therapy for AHF patients resulted in a shorter duration of hospitalization without increased adverse events.

Nursing care of a patient with programmed cell death protein-1 immunotherapy-related myocarditis combined with coronary heart disease

This report introduced and summarized the nursing care experience for a senior patient with lung cancer and developed programmed cell death protein 1(PD-1)immunotherapy-related myocarditis combined with coronary heart disease(CHD)after receiving said treatment.In this case,immune myocarditis with CHD occurred shortly after implementing the PD-1 immunotherapy,yet the patient presented no clinical symptoms.Frequent nursing attention and close observation are so required for monitoring the patient’s status and updating the physicians for a swift control of the myocarditis.For this case,nursing care procedures vital for the successful recovery of the patient included condition observation,position management,pre-and postcoronary angiography care,infection prevention,hemorrhage prevention,venous access port maintenance,pain care,trachea care,psychological care,diet care,environment management,and health education.After receiving effective,successful treatment and care,the patient was discharged after 13 days of treatment with generally satisfying overall conditions.

Ultrasonographic Segmentation of Fetal Lung with Deep Learning

The morbidity and mortality of the fetus is related closely with the neonatal respiratory morbidity, which was caused by the immaturity of the fetal lung primarily. The amniocentesis has been used in clinics to evaluate the maturity of the fetal lung, which is invasive, expensive and time-consuming. Ultrasonography has been developed to examine the fetal lung quantitatively in the past decades as a non-invasive method. However, the contour of the fetal lung required by existing studies was delineated in manual. An automated segmentation approach could not only improve the objectiveness of those studies, but also offer a quantitative way to monitor the development of the fetal lung in terms of morphological parameters based on the segmentation. In view of this, we proposed a deep learning model for automated fetal lung segmentation and measurement. The model was constructed based on the U-Net. It was trained by 3500 data sets augmented from 250 ultrasound images with both the fetal lung and heart manually delineated, and then tested on 50 ultrasound data sets. With the proposed method, the fetal lung and cardiac area were automatically segmented with the accuracy, average IoU, sensitivity and precision being 0.98, 0.79, 0.881 and 0.886, respectively.

A CASE OF TRICUSPID ENDOCARDITIS WITH SUBSEQUENT LUNG ABSCESS

THE incidence of isolated right heart infective endocarditis （IE） is far less common than that of left heart. Clinical presentation is often associated with pulmonary manifestations. The main symptoms include high fever, chest pain, and dyspnea due to septic pulmonary emboli. Degenerative valvular disease, congenital heart diseases, prosthetic valves, long-term hemodialysis, diabetes mellitus predispose patients at increased risk of IE.1 In young persons, IE may be associated with intravenous drug abuse.2 This report dealt with a young patient who had none of the risk factors mentioned above. He was diagnosed and treated for lung abscess and septemia for one and a half months. Further investigation unveiled infective vegetation on tricuspid valve. Following surgical resection of the vegetation, fever and respiratory symptoms completely remitted. The mechanism of the IE occurred on the normal native tricuspid valve is proposed.

Oval-Shaped Radiographic Opacity Mimicking a Lung Mass

Phantom tumor of the lung is an infrequent presentation of volume overload in congestive heart failure. This finding is often mistaken for a lung mass that leads to extensive workup and unnecessary treatments. A 75-year-old male was evaluated for a right lower lobe rounded opacity. A transthoracic echocardiogram showed normal left ventricular function. Biopsy of the mass was unremarkable. Patient was managed with diuretics, and subsequent lung imaging revealed resolution of the opacity.

晚期心力衰竭患者院内肺部感染的影响因素分析

目的分析晚期心力衰竭患者发生院内肺部感染的影响因素,并评估这些影响因素的诊断价值。方法纳入晚期心力衰竭患者485例,根据患者入院期间是否发生肺部感染进行分组。收集患者入院期间一般资料和实验室及影像学检查。比较两组患者的基线资料。采用单因素及多因素Logistic回归分析明确晚期心力衰竭患者肺部感染的影响因素,采用ROC曲线评估其诊断价值。结论相较于无肺部感染的心力衰竭患者,肺部感染的心力衰竭患者BNP和NYHA分级增加,HDL-C和LVEF水平降低(P<0.05)。单因素及多因素Logistic回归分析表明,HDL-C、LVEF、BNP、NYHA是晚期心力衰竭患者发生院内肺部感染的独立影响因素。ROC曲线显示,HDL-C联合LVEF、BNP、NYHA对晚期心力衰竭患者院内肺部感染的发生具有一定的诊断价值(P<0.001)。结论HDL-C、LVEF、BNP、NYHA是晚期心力衰竭患者肺部感染的独立影响因素。

无创呼吸机辅助振动排痰对ICU急性心力衰竭患者心功能指标的影响

目的观察无创呼吸机辅助振动排痰对重症监护病房(ICU)急性心力衰竭患者心功能指标水平的影响.方法选择2020年9月至2023年3月在浙江省立同德医院ICU接受治疗的120例急性心力衰竭患者作为研究对象.将患者按随机数字表法分为对照组和试验组,每组60例.两组患者均给予常规对症治疗和无创呼吸机辅助通气,对照组给予常规护理干预,试验组给予无创呼吸机辅助振动排痰干预.记录两组患者干预2周后动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、脉搏血氧饱和度(SpO_(2))、呼吸频率(RR)、心率、血压、中心静脉压、血清中和超声下心功能指标及预后情况.结果两组干预后PaO_(2)、SpO_(2)、左室射血分数(LVEF)均较干预前明显升高,而PaCO_(2)、RR、心率、血压、中心静脉压、N末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白T(cTnT)、左室收缩期末内径(LVESD)、左室舒张期末内径(LVEDD)均较干预前明显降低(均P<0.05).与对照组比较,试验组干预后PaO_(2)、SpO_(2)、血压、中心静脉压、LVEF均明显升高[PaO_(2)(mmHg,1 mmHg≈0.133 kPa):68.24±5.81比59.63±6.86,SpO_(2):0.95±0.03比0.87±0.04,收缩压(mmHg):116.05±4.11比104.13±3.95,舒张压(mmHg):68.19±4.13比62.85±4.12,中心静脉压(mmHg):9.42±1.29比8.14±1.42,LVEF:0.49±0.05比0.43±0.04,均P<0.05],PaCO_(2)、RR、心率、NT-proBNP、cTnT、LVESD、LVEDD均明显降低[PaCO_(2)(mmHg):42.12±4.08比52.13±4.61,RR(次/min):18.85±1.75比21.54±2.51,心率(次/min):89.53±8.14比101.11±10.26,NT-proBNP(ng/L):1687.25±589.67比2145.36±751.03,cTnT(ng/L):70.58±5.15比81.45±6.89,LVESD(mm):34.51±3.11比38.89±3.55,LVEDD(mm):46.11±3.22比49.74±3.75,均P<0.05].试验组机械通气时间、ICU住院时间、肺部感染缓解时间均较对照组明显缩短[机械通气时间(h):72.14±10.06比78.96±12.97,ICU住院时间(d):10.74±2.15比12.88±3.26,肺部感染缓解时间(d):3.58±0.79比5.14±1.12,均P<0.05],肺部感染发生率明显降低[1.67%(1/60)比11.67%(7/60),P<0.05],但试验组和对照组28d病死率比较差异无统计学意义[10.00%(6/60)比21.67%(13/60),P>0.05].结论无创呼吸机辅助振动排痰可改善低氧血症症状和心功能,稳定血流动力学,缩短ICU急性心力衰竭患者病程,降低肺部感染的发生.

TNIP1基因单核苷酸多态性及其mRNA表达水平与老年慢性心力衰竭患者肺部感染的相关性分析

目的探讨肿瘤坏死因子诱导蛋白3相互作用蛋白1(TNFAIP3-interacting protein 1,TNIP1)基因单核苷酸多态性及其mRNA表达水平与老年慢性心力衰竭患者肺部感染的相关性。方法选择2019年10月至2022年10月于上海建工医院重症医学科就诊的130例老年慢性心力衰竭患者作为研究对象,根据是否于院内发生肺部感染分为感染组(32例)和未感染组(98例)。对TNIP1基因的两个SNP位点rs6889239(T>C)、rs17728338(A>G)进行基因分型,并检测外周血TNIP1基因的mRNA表达水平。结果TNIP1基因rs6889239位点在感染组和非感染组之间的基因型分布以及等位基因频率的差异均无统计学意义(P>0.05);两组的rs17728338位点AA、AG、GG基因型分布比较差异有统计学意义(P<0.05),且感染组等位基因G的频率显著高于未感染组(P<0.05)。相较于未感染组,感染组患者的外周血TNIP1基因mRNA表达水平显著增加,差异有统计学意义(P<0.001)。受试者工作特征(Receiver operating characteristic,ROC)曲线分析结果显示外周血TNIP1基因表达水平预测慢性心力衰竭患者发生肺部感染的灵敏度和特异度分别为71.9%和95.9%。感染组和非感染组TNIP1基因rs6889239位点不同基因型患者的外周血TNIP1基因的表达水平比较差异均无统计学意义(P>0.05),而rs17728338位点不同基因型患者的外周血TNIP1基因表达水平比较差异有统计学意义(P<0.05)。结论TNIP1基因rs17728338表达水平与老年慢性心力衰竭患者发生肺部感染有关。

基于中和医派以丹参注射液治疗肺动脉高压所致右心衰竭临床观察

目的 研究中和派思想指导下,以丹参注射液治疗肺动脉高压所致右心衰竭的临床效果。方法 收集2021年1月—2022年2月九江市第一人民医院收治的肺动脉高压伴右心衰竭患者111例,按随机数字表法分为3组,分别为对照组、西药组和联合组,每组37例;对照组采用临床常规治疗方案,西药组在对照组的基础上加用托伐普坦,联合组在西药组基础上加用丹参注射液,3组均治疗28 d,观察临床疗效及血清N末端B型利钠肽原(NT-proBNP)、β2微球蛋白(β2-MG)水平。结果联合组总有效率为94.59%(35/37)、西药组总有效率为89.19%(33/37),均显著高于对照组的78.38%(29/37)(P<0.05)。与治疗前比较,3组中医临床症状体征积分均明显降低,且治疗后联合组中医临床症状体征积分低于西药组及对照组(P<0.05)。与治疗前比较,3组患者NT-proBNP、β2-MG水平均明显降低(P<0.05),且联合组NT-proBNP、β2-MG水平明显低于西药组及对照组(P<0.05)。结论 丹参注射液联合托伐普坦治疗肺动脉高压伴右心衰竭,能够显著提高临床效果、改善临床症状、降低患者血清NT-proBNP、β2-MG水平,值得临床应用。

疼痛管理联合加速康复外科理念在肺癌合并冠心病患者围手术期的应用效果

目的探讨疼痛管理联合加速康复外科理念在肺癌合并冠心病患者围手术期的应用效果。方法根据干预方式的不同将62例肺癌合并冠心病手术患者分为观察组(n=33)和对照组(n=29),对照组患者围手术期给予常规干预,观察组患者在对照组的基础上给予疼痛管理联合加速康复外科理念。比较两组患者的围手术期指标、疼痛情况[视觉模拟评分法(VAS)]、负性情绪[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]及术后并发症发生情况。结果观察组患者首次排气时间、首次排便时间、引流管拔除时间、住院时间均短于对照组,术后并发症总发生率低于对照组,差异均有统计学意义(P﹤0.05)。术后1天、3天、1周,两组患者VAS评分均呈下降趋势,且观察组患者VAS评分均低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者HAMA、HAMD评分均低于本组干预前,观察组患者HAMA、HAMD评分均低于对照组,差异均有统计学意义(P﹤0.05)。结论疼痛管理联合加速康复外科理念应用于肺癌合并冠心病患者围手术期,能够减轻术后疼痛、改善负性情绪、降低术后并发症发生率,并且促进患者术后恢复。