摘要
目的探讨全腔镜手术联合加速康复外科(ERAS)理念的呼吸功能锻炼对食管癌患者术后肺部并发症、术后疼痛、下床时间、胸腔引流量、拔管时间以及住院时间的影响。方法选择2018年6月至2020年6月在扬州大学附属医院行食管癌手术的160例患者,随机分为4组,每组40例。A组患者采用全腔镜食管癌手术,术前行ERAS理念宣教和呼吸功能锻炼;B组采用传统开放手术,术前行ERAS理念宣教和呼吸功能锻炼;C组采用全腔镜食管癌手术,术前行常规入院宣教和护理指导,常规呼吸功能锻炼,无术前ERAS理念宣教;D组采用传统开放手术,行常规入院宣教和护理指导,常规呼吸功能锻炼,无术前ERAS理念宣教。记录4组患者术后肺部并发症的发生数量、术后疼痛、下床时间、拔管时间及住院时间。结果与B、C两组比较,A组肺部并发症发生率明显降低,下床时间、拔管时间和住院时间明显缩短;A组较B组术后疼痛明显减轻,差异均有统计学意义(P<0.05)。与D组比较,B组肺部并发症发生率、下床时间、拔管时间和住院时间明显减少,差异均有统计学意义(P<0.05)。与D组比较,C组术后疼痛、肺部并发症发生率均降低,下床时间、拔管时间和住院时间均缩短,差异有统计学意义(P<0.05)。结论对于食管癌手术患者,ERAS理念指导下的呼吸功能锻炼联合全腔镜手术可有效降低肺部并发症的发生率和术后疼痛,缩短下床时间、拔管时间以及住院时间。
Objective To explore the effects of full laparoscopic surgery combined with enhanced recovery after surgery concept of respiratory function exercise on postoperative pulmonary complications,postoperative pain,time to get out of bed,chest drainage,extubation time and hospitalization for patients with esophageal cancer.Methods A total of 160 patients who underwent esophageal cancer surgery at the Affiliated Hospital of Yangzhou University from June 2018 to June 2020 were randomly divided into 4 groups,40 patients in each group.Patients in group A underwent full laparoscopic esophageal cancer surgery,preoperative ERAS concept education and respiratory function exercise;group B adopted traditional open surgery,preoperative ERAS concept education and respiratory function exercise;group C adopted full laparoscopic esophageal cancer surgery,carry out routine admissions and nursing guidance,regular breathing exercises,without preoperative ERAS concept education;group D uses traditional open surgery,routine admissions and nursing guidance,regular respiratory function exercises,without preoperative ERAS concept education.The number of postoperative pulmonary complications,postoperative pain,time to get out of bed,extubation time and hospital stay were recorded for the four groups.Results Compared with group B and group C,the incidence of pulmonary complications in group A was significantly reduced,and the time to get out of bed,time to extubation and hospital stay in group A were significantly shortened;postoperative pain was significantly decreased in group A than that in group B,and the difference was statistically significant(P<0.05).Compared with group D,the incidence of pulmonary complications,time to get out of bed,time to extubation and length of hospital stay in group B were significantly reduced,and the difference was statistically significant(P<0.05).Compared with group D,the incidence of postoperative pain and pulmonary complications were reduced in group C,the time to get out of bed,the time to extubation and t
作者
施庆彤
包阳
钱军
卞晓蕾
Shi Qingtong;Bao Yang;Qian Jun;Bian Xiaolei(Department of Thoracic Surgery,the Affiliated Hospital of Yangzhou University,Yangzhou 225000,China;Department of Thoracic Surgery,Yancheng First People’s Hospital,Yancheng 224000,China;Department of Nursing,Yangzhou Yihe Rehabilitation Hospital,Yangzhou 225000,China)
出处
《中华胸部外科电子杂志》
2020年第4期214-219,共6页
CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition
关键词
食管癌
快速康复外科
全腔镜手术
Esophageal cancer
Enhanced recovery after surgery
Full laparoscopic surgery
