摘要
目的探讨快速康复外科理念在达芬奇机器人肺癌根治手术中的应用价值。方法选取北部战区总医院自2018年10月至2019年4月收治的60例行达芬奇机器人肺癌根治手术的患者为研究对象。将患者随机分入常规组和ERAS组,每组各30例。常规组患者接受达芬奇机器人肺癌根治手术+胸外科常规围术期管理,ERAS组在常规组基础上结合快速康复外科治疗模式。比较两组患者的术后24、48 h视觉模拟评分,围术期相关指标(手术时间、引流时间、术后住院时间、术后住院费用),以及术后并发症发生率。结果两组患者均顺利完成手术,无死亡,无二次开胸,均于拔除引流管后痊愈出院。ERAS组术后24、48 h视觉模拟评分分别为(4.51±1.36)分、(3.12±1.26)分,均低于常规组的(6.10±1.37)分、(4.58±1.32)分,差异有统计学意义(P<0.05)。常规组和ERAS组手术时间分别为(118.73±50.46)min、(101.23±56.30)min,差异无统计学意义(P>0.05);引流时间分别为(6.84±2.61)d、(5.40±2.77)d,差异无统计学意义(P>0.05)。ERAS组术后住院时间为(6.75±2.43)d,短于常规组的(9.84±3.61)d,差异有统计学意义(P<0.05)。ERAS组术后住院费用为(7.46±0.42)万元,少于常规组的(8.04±0.96)万元,差异有统计学意义(P<0.05)。ERAS组术后并发症发生率为10.0%(3/30),低于常规组的33.3%(10/30),差异有统计学意义(P<0.05)。结论在达芬奇机器人肺癌根治手术中结合快速康复外科理念可有效缓解患者疼痛症状,降低术后并发症发生率,缩短术后住院时间,减轻经济负担。
Objective To investigate the value of enhanced recovery after surgery in the radical resection of lung cancer by Da Vinci surgical system.Methods A retrospective study was performed on 60 cases of patients who were admitted and underwent radical resection of lung cancer by Da Vinci surgical system from October 2018 to April 2019.Patients were randomly divided into the conventional group and the ERAS group,with 30 patients in each group.Patients in the conventional group received Da Vinci robotic radical lung cancer surgery+routine perioperative management of thoracic surgery,while patients in the ERAS group were treated with rapid rehabilitation surgery based on the conventional group.Visual simulation scores of the two groups were compared 24 and 48 hours after surgery,perioperative indicators(operation time,drainage time,postoperative hospitalization time,postoperative hospitalization costs),and postoperative complication rates.Results Both groups of patients successfully completed the operation,without death or secondary thoracotomy,and recovered after removal of the drainage tube.At 24 and 48 hours after surgery,the visual simulation scores of the ERAS group were(4.51±1.36)points and(3.12±1.26)points,respectively,which were lower than those of the conventional group[(6.10±1.37)points and(4.58±1.32)points],with statistically significant differences(P<0.05).The operating time of the conventional group and the ERAS group was(118.73±50.46)minutes and(101.23±56.30)minutes,respectively,with no significant difference(P>0.05).The drainage time was(6.84±2.61)days and(5.40±2.77)days,respectively,with no significant difference(P>0.05).The postoperative hospitalization time in the ERAS group was(6.75±2.43)days,shorter than that in the conventional group[(9.84±3.61)days],P<0.05.The postoperative hospitalization cost in the ERAS group was(74.6±4.2)thousand yuan,less than that in the conventional group[(80.4±9.6)thousand yuan],P<0.05.The incidence of postoperative complications in the ERAS group was 10.0%(3/30),
作者
王希龙
吴子恒
许世广
王彬
刘博
徐惟
丁仁泉
刘星池
李博
王述民
WANG Xi-long;WU Zi-heng;XU Shi-guang;WANG Bin;LIU Bo;XU Wei;DING Ren-quan;LIU Xing-chi;LI Bo;WANG Shu-min(Department of Thoracic Surgery,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《临床军医杂志》
CAS
2020年第3期253-256,共4页
Clinical Journal of Medical Officers
关键词
快速康复外科
达芬奇机器人
肺癌根治手术
Enhanced recovery after surgery
Da Vinci surgical system
Radical resection of lung cancer
