摘要
目的探讨加速康复外科理念在行胸腔镜下肺结节切除术患者中的应用价值。方法选取2021年1~12月于南京医科大学附属脑科医院行胸腔镜下肺结节切除术的100例患者为研究对象,按信封法随机分为2组,各50例。对照组行胸腔镜术后常规护理干预,观察组行胸腔镜术后加速康复外科护理。比较2组患者的呼吸功能、炎症反应、疼痛程度、住院时间和术后并发症。结果术后3 d和1个月,2组患者的用力肺活量、第1秒用力呼气容积、最大吸气压和最大呼气压均低于术前,但观察组在术后1个月的上述指标水平均高于对照组,差异均有统计学意义(P均<0.05)。术后72 h,2组的肿瘤坏死因子-α、白介素-6和C反应蛋白水平均高于术前,且观察组的上述炎症因子水平均低于对照组,差异均有统计学意义(P均<0.05)。相较于对照组,观察组在术后72 h的视觉模拟评分法评分更低,术后住院时间更短,术后并发症总发生率更少,差异均有统计学意义(P均<0.05)。结论加速康复外科理念有助于加快行胸腔镜下肺结节切除术患者的术后恢复速度,改善其呼吸功能,减轻疼痛程度和炎症反应,并减少并发症的发生。
Objective To explore the application value of fast-track surgery concept in patients with pulmonary nodules undergoing thoracoscopic surgery.Methods A total of 100 patients who underwent thoracoscopic resection of pulmonary nodules at the Affiliated Brain Hospital of Nanjing Medical University from January to December 2021 were selected as the study subjects.They were randomly divided into two groups using envelope randomization,with 50 patients in each group.The control group received routine nursing intervention after thoracoscopic surgery,while the observation group received fast-track surgery nursing after thoracoscopic surgery.The respiratory function,inflammatory response,pain intensity,hospital stay,and postoperative complications of the two groups were compared.Results At 3 days and 1 month after surgery,the forced vital capacity,forced expiratory volume in 1 second,maximal inspiratory pressure,and maximal expiratory pressure of the two groups were lower than those before surgery,but the levels of the above indicators in the observation group were higher than those in the control group at 1 month after surgery.The differences were statistically significant(all P<0.05).At 72 h after surgery,the levels of tumor necrosis factor-α,interleukin-6,and C-reactive protein in the two groups were higher than those before surgery,and the levels of the aforementioned inflammatory factors in the observation group were lower than those in the control group,with statistical significance(all P<0.05).Compared with the control group,the observation group had a lower Visual Analogue Scale score at 72 h after surgery,a shorter postoperative hospital stay,and a lower overall incidence of postoperative complications,with statistical significance(all P<0.05).Conclusion The fast-track surgery concept helps to promote the postoperative recovery,improve the respiratory function,alleviate the pain and inflammatory response,and reduce the incidence of complications in patients with pulmonary nodules undergoing thoracoscopic surgery.
作者
朱楸璐
杨艳
杨阳
ZHU Qiulu;YANG Yan;YANG Yang(The Affiliated Brain Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029,China)
出处
《中西医结合护理（中英文）》
2023年第6期5-8,共4页
Journal of Clinical Nursing in Practice
关键词
肺结节
胸腔镜手术
加速康复外科理念
护理干预
pulmonary nodule
thoracoscopic surgery
fast-track surgery concept
nursing intervention
