快速康复外科理念在肺癌围手术期的应用-研究

《快速康复外科理念在肺癌围手术期的应用-研究》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、温州医学院硕士学位论文发症的发生率，减轻疼痛，缩短术后胸腔引流管置管时间和术后住院时间，加快病人康复。尤其低肺功能患者可明显减少术后肺部并发症的发生率，从中受益。关键词：快速康复外科，肺肿瘤，肺叶切除，胸腔镜手术，肺部并发症4温州医学院硕士学位论文ApplicationofFastTrackSurgeryintheperioperativeManagementofPatientswithLungCancerAbstract0bjective．ToinvestigatethefeasibilityandsafetyofFTSapplicationinlungcancersurgery，

2、andtofurtherassesstheadvantagesofFTSintheperioperativeperiodoflungcancer．Methods：AtotalofsixtypatientsundergoingpulmonaryIobectomyforlungcancerfrOmmarch2012toFebruary2013wererandomlydividedintotwogroups．Aexperimentalgroup(bytheFTSregimen)andcontrolgroup(bythetraditionalmethods)wascompared．Thema

3、indifferencesbetweenthetwogroupsconsistedinsurgicaImethods(video—assistedthoracoscopicsurgeryVStraditionaIthoracotomy)，analgesia(patientcontrolledepiduralanalgesia，PCEAMSpatientcontrolledintravenousanalgesia，PCIA)andpreoperativefasting(2hVS8h)．Studyendpointswerepulmonarycomplications(pneumonia，

4、atelectasis，pleuraleffusion，prolongerairleak>7d)，overallmorbidity，postoperativestress，postoperativepaindegrees，postoperativechesttubedrainageandhospitalstay．Results：Bothstudygroupsweresimilarintermsofage，sex，Tissuetype，pTNMstage，preoperativeforcedexpiratoryvolumeinonesecond(FEVl)andAmericanSoci

5、etyofAnesthesiOIOgistsscore．Twogroupshadnodeaths．Therateofpostoperativepulmonarycomplicationswas44．8％intheCTSgroupand14．3％intheFTSgroup(p=0．012)．Theoverallmorbidity(anycomplicationdocumented)didnotsignificantlydifferbetweentheFTSgroup(25．0％)andtheCTSgroup(48．3％)(p=O．069)．Thetimeofchesttubedrain

6、agewas3．5±2。2daysintheFTSgroupand7．3±4．3daysintheCTSgroup(p<0．01)．Thehospitalstayinbothgroupswascomparable：6．0±2．7daysversus10．2±5．0days，p<0．01．TheVASscoreofpostoperativepainat2h，6h，12h，24hand48hintheFTSgroupalIsignificantlydecreasedcomparedtotheCTSgroup(p<0．05)．ThepostoperativeCRPlevelsat1d，3d

7、，5dintheFTSgroupallsignificantlydeceasedcomparedtotheCTSgroup(p=0．03，p=0．004，p=0．03，respectively)．AsubgroupofpatientswithreducedpreoperativeFEVl(<75％ofpredictedvalue)experiencedlesspulmonarycomplicationsinFTSgroup(8．33％VS46．67％，p=