摘要
目的:综合评价加速康复外科理念在老年肺癌患者的应用效果。方法:回顾性分析2017年10月—2020年10月在我院行肺癌手术的老年患者(年龄≥60岁)224例,依据康复理念不同分为传统组131例和加速康复组93例,采用倾向性评分匹配功能进行匹配,比较匹配后两组患者术后康复情况、术后并发症、术后肺功能等指标。结果:采用1∶1最邻近匹配法,经倾向性评分匹配法成功匹配90对患者。加速康复组的尿管留置时间、胸管留置时间、排便时间及术后住院时间均优于传统组(P<0.05);两组术后1天的视觉模拟疼痛评分(VAS)对比无明显差异,而加速康复组的术后3天、7天的VAS分值显著低于传统组(P<0.05)。两组术后1天的C反应蛋白(CRP)、降钙素原(PCT)水平未见明显差异(P>0.05),而加速康复组术后3、7天的CRP、PCT均较传统组明显下降(P<0.05)。加速康复组术后1个月的肺功能指标FEV1、FVC、PEF均明显优于传统组(P<0.05)。加速康复组术后肺不张、肺炎、包裹性胸腔积液、肺漏气及下肢深静脉血栓的发生率明显低于传统组(P<0.05)。结论:老年肺癌患者围术期应用加速康复理念,可以减少并发症的发生,促进肺功能恢复,加速患者康复。
Objective:To evaluate the effect of enhanced recovery after surge(ERAS)in elderly patients with lung cancer.Method:A total of 224 elderly patients(aged ≥ 60) who underwent lung cancer surgery in our hospital from October 2017 to October 2020 were retrospectively analyzed. According to different rehabilitation concepts,they were divided into the traditional group(131 cases) and the enhanced recovery group(93 cases). The propensity score matching function was used to match. The postoperative rehabilitation, postoperative complications,postoperative lung function and other indicators of the two groups were compared.Result:Ninety pairs of patients were successfully matched by 1∶1 nearest neighbor matching method and propensity score matching method. The urinary catheter indwelling time, chest tube indwelling time, defecation time and postoperative hospital stay in ERAS group were better than those in the traditional group(P<0.05);there was no significant difference in VAS scores between the two groups on the 1st day after operation,while the VAS scores on the 3rd and 7th day after operation in the enhanced recovery group were significantly lower than those in the traditional group(P<0.05). There was no significant difference in CRP and PCT between the two groups on the 1st day after operation(P>0.05),while CRP and PCT in the enhanced recovery group were significantly lower than those in the traditional group on the 3rd and 7th day after operation(P<0.05). FEV1,FVC and PEF in ERAS group were significantly better than those in the traditional group(P<0.05). The incidence of atelectasis,pneumonia,encapsulated pleural effusion,pulmonary leakage and lower extremity deep venous thrombosis in ERAS group was significantly lower than that in the traditional group(P<0.05).Conclusion:The application of ERAS in elderly patients with lung cancer during perioperative period can reduce the incidence of complications,promote the recovery of lung function and accelerate the recovery of patients.
作者
张旭刚
李维青
李宝重
李志田
姜福胜
ZHANG Xugang;LI Weiqing;LI Baozhong(Department of Thoracic Surgery,Beijing Shijitan Hospital,Capital Medical University,Beijing,100038)
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2022年第8期1068-1072,1078,共6页
Chinese Journal of Rehabilitation Medicine
关键词
老年人
肺癌
加速康复外科
肺功能
elderly
lung cancer
enhanced recovery after surgery
lung function
