摘要
目的通过研究不同时间行纤维支气管镜吸痰对肺癌患者术后恢复的影响,探讨肺癌术后纤维支气管镜吸痰的最佳时机。方法纳入该科2017年6月至2018年6月同一治疗组128例肺癌患者作为研究对象,分为拔气管插管前吸痰组(A组,n=35)、术后第1天吸痰组(B组,n=31)、术后第2天吸痰组(C组,n=32)、术后第3天吸痰组(D组,n=30)。对比分析4组患者血氧分压、二氧化碳分压、白细胞计数、中性粒细胞比值、降钙素原水平、肺部感染情况、住院费用及住院时间。结果(1)术后住院时间:4组患者平均住院时间分别为(6.31±1.23)、(6.52±1.26)、(6.63±1.10)d和(7.00±1.05)d,A组与D组住院时间差异有统计学意义(P=0.046)。(2)住院费用:4组患者平均住院费用分别为(61472±10692)、(61478±11545)、(64142±12391)元和(67520±15745)元,A组与D组,B组与D组住院费用差异具有统计学意义(P<0.05)。(3)肺部感染:A组2例,B组3例,C组5例,D组8例。A组与D组之间差异有统计学意义(χ2=5.364,P=0.021)。结论肺癌术后纤维支气管镜吸痰时间越早越好。越早行纤维支气管镜吸痰能改善患者肺通气功能,减少气道炎症反应、降低肺部感染,从而缩短住院时间,降低住院费用。
Objective To study the effect of sputum aspiration at different times under bronchoscopy on the postoperative recovery of lung cancer patients,and explore the best intervention time for sputum aspiration after lung cancer operation.Methods A total of 128 patients with lung cancer in the same treatment group in this department from June 2017 to June 2018 were included in the study and divided into the group of sputum aspiration before endotracheal intubation(group A,n=35),the group of sputum aspiration at postoperative 1st day(group B,n=31),the group of sputum aspiration at postoperative 2nd day(group C,n=32),the group of sputum aspiration at postoperative 3rd day(group D,n=30).The oxygen partial pressure,carbon dioxide partial pressure,white blood cell,neutrophil ratio,procalcitonin,pulmonary infection,hospitalization expenses and hospitalization time were compared in the 4 groups.Results(1)Postoperative hospital stay:the average hospital stay in group A,B,C and D was(6.31±1.23),(6.52±1.26),(6.63±1.10)and(7.00±1.05)d,respectively,the difference were statistically significant between group A and D(P=0.046).(2)Hospitalization expenses:the average hospitalization expenses of group A,B,C and D was(61472±10692),(61478±11545),(64142±12390)and(67520±15744)yuan,respectively.The difference in hospital stay was statistically significant between group A and D,B and D(P<0.05).(3)Pulmonary infection:there are 2 cases in group A,3 cases in group B,5 cases in group C,and 8 cases in group D.The difference wasstatistically significant between group A and D(χ2=5.364,P=0.021).Conclusion The earlier sputum aspiration under fiberoptic bronchoscope after thoracic surgery,the better.The earlier sputum aspiration can improve lung ventilation function and reduce the airway inflammation,hospital stays and hospitalization costs.
作者
李林峻
张诚
王小文
周瑞琴
罗骏
田雷
吴庆琛
LI Linjun;ZHANG Cheng;WANG Xiaowen;ZHOU Ruiqin;LUO Jun;TIAN Lei;WU Qingchen(Department of Cardiothoracic Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《重庆医学》
CAS
2021年第1期72-76,共5页
Chongqing medicine
基金
重庆市科委基金资助项目(CSTC2014jcyjA10089)。
关键词
肺癌术后
纤维支气管镜
吸痰
吸痰时间
气道管理
postoperative lung cancer
bronchoscopy
suction
suction timing
airway management
