胸腔镜下快速康复外科在肺癌手术中的应用疗效

目的 探讨胸腔镜下快速康复外科流程在肺癌手术中应用的疗效.方法 回顾性分析2010年10月～2012年10月来我院住院行肺癌根治手术的患者60例,采用完全随机分组法分为对照组和观察组.对照组患者给予胸腔镜下开胸手术,观察组采用胸腔镜下快速康复外科流程的治疗模式,比较两组患者术后相关恢复指标及术后并发症的发生率.结果 两组肺癌患者手术顺利,无死亡病例发生,其中观察组在保留胸管时间、保留尿管时间、肛门排气时间、住院时间、住院费用上分别为（5.1±0.8）d、（8.4±3.2）d、（1.1±0.8）d、（12.8±4.1）d、（42.6±4.9）千元,较对照组恢复更快,差异有统计学意义（P＜0.05）;观察组术后并发支气管胸膜瘘、肺部感染、心血管疾病、切口感染、尿路感染的发生率分别为2例（6.7％）、2例（6.7％）、1例（3.3％）、1例（3.3％）、1例（3.3％）,较对照组术后并发症发生率低,两组并发肺部感染、心血管疾病、切口感染发生率比较,差异有统计学意义（P＜0.05）.结论 在胸腔镜下将快速康复外科流程应用于肺癌手术中,能有效减少患者术后拔管时间、住院时间、费用等,术后恢复更快,且降低患者并发症发生率,临床上值得进一步研究.

Application of Thoracoscopic Surgical Treatment Combined with Rapid Recovery in Lung Cancer Surgery

Objective To investigate the efficacy of combined application of quickly thoracoscopic surgical rehabilitation process in lung cancer surgery. Methods A retrospective analysis from October 2010 to October 2012 in our hospital with lung cancer radical surgery patients, 60 cases selected for the study were randomly divided into two groups, the control group was treated with thoracoscopic thoracic surgery, observation group was treated with thoracoscopic surgical rehabilitation process combined with the fast mode of treatment with rapid recovery, including preoperative education, reasonable analgesia, postoperative rehabilitation guidance, postoperative dietary guidance, and follow-up surveys. The two groups of patients were compared with the postoperative recovery related index and incidence of postoperative complications. Results The two groups of patients with lung cancer surgery went well, no deaths occurred in the observation group. The chest tube retention time （5.1 ±0. 8）d, retention catheter time （8.4±3.2）d, flatus （1.1±0.8）d, the length of stay （12.8±4. 1） d, hospital costs （42.6±4.9）thousand yuan, were all superior over the control group （P〈0.05） ; observation group in the bronchial fistula, pulmonary infection, cardiovascular disease, wound infection, urinary tract infection rates were： 2 cases （6.7%）, 2 cases （6. 7%）, 1 case （3.3%）, 1 case （3. 3%）, 1 case （3. 3%）, respectively lower than the control group. The postoperative complications occurred in lung infections, cardiovascular disease, wound infection in observation group were statistically significant from control group （P〈0. 05）. Conclusion Thoracoscopic surgery combined with rapid recovery processes used in lung surgery can effectively reduce postoperative extubation time, the length of stay, costs and so on, with faster postoperative recovery, and is worthy of further clinical studies.