胸腔镜肺叶切除联合加速康复外科实践治疗非小细胞肺癌的临床研究

目的:探讨加速康复外科（ERAS）应用于胸腔镜非小细胞肺癌（NSCLC）手术治疗的临床效果。方法:选取50例NSCLC拟行胸腔镜手术根治的病人，将其随机分为对照组（25例）及观察组（25例）。对照组采取单纯胸腔镜手术根治，观察组采取胸腔镜手术根治联合ERAS流程治疗模式进行治疗，比较2组病人术后肺部感染发生率、疼痛程度、肺不张发生率、胸腔积液发生率、术后住院时间及住院总费用等情况。结果:与对照组相比，观察组术后1、6及12 h疼痛评分明显降低（P<0.01），观察组内各时点内比较差异无统计学意义（P>0.05）。观察组术后并发症的发生率为4.0%，低于对照组的20.0%（P>0.05）。与对照组相比，观察组病人的住院时间明显缩短（P<0.05）。结论:胸腔镜联合ERAS方案对于NSCLC病人来说，能有效加快其术后康复，预防并发症，从而缩短长时间住院，降低住院费用，值得临床进一步推广应用。

Clinical study of thoracoscopic lobectomy combined with ERAS in the treatment of non-small cell lung cancer

Objective:To investigate the application effects of the concept of enhanced recovery after surgery(ERAS) in non-small cell lung cancer patients treated with thoracoscopic lobectomy.Methods:Fifty non-small cell lung cancer patients scheduled by thoracoscopic lobectomy were randomly divided into the control group(25 cases) and observation group(25 cases).The control group were treated with simple thoracoscopic surgery,and the observation group was treated with thoracoscopic radical surgery combined with ERAS.The incidence rates of lung infection after operation,atelectasis and pleural effusion,degree of pain,postoperative hospital ization time,and total hospitalization expense between two groups were compared.Results:The pain scores in observation group were significantly lower than that in control group after 1 hour,6 hours and 12 hours of operation(P<0.05),and the difference of the intra-group comparison was not statistically significant(P>0.05).The incidence rate of postoperative complication in observation group(4%) was significantly lower than that in control group(20%)(P<0.05).The postoperative hospitalization time in observation group was significantly shorter than that in control group(P<0.05).Conclusions:The application of thoracoscopy combined with ERAS in treating non-small cell lung cancer can effectively promote the postoperative rehabilitation,reduce complications,shorten hospitalization time and reduce hospitalization expense,which is worthy of further clinical application.