摘要
目的探讨基于加速康复外科理念的多模式麻醉管理在胸腔镜下肺叶切除术围手术期的临床效果。方法选取2021年4月至2023年3月赣州市立医院收治的60例择期行胸腔镜下肺叶切除术患者作为研究对象,按照随机数字表法将患者分为试验组(30例)和对照组(30例)。对照组采用常规处理原则,试验组采用实施加速康复外科措施的处理原则。比较两组患者术后拔除胸腔引流管时间、术后开始下床时间、术后肛门第一次排气时间以及平均住院时间。比较两组患者术后6、12、24、48、72 h静息状态视觉模拟评分法(VAS)评分,比较两组患者术后6 h内恶心呕吐、胸腔积液、肺部感染、肺不张和低体温等并发症的发生情况。结果试验组患者术后拔除胸腔引流管时间、术后开始下床时间、术后肛门第一次排气时间以及平均住院时间均短于对照组,差异有统计学意义(P<0.05)。试验组患者术后6、12、24、48 h静息状态VAS评分低于对照组,差异有统计学意义(P<0.05);两组患者术后72 h静息状态VAS评分比较,差异无统计学意义(P>0.05)。整体分析结果显示,两组患者术后6、12、24、48、72 h静息状态VAS评分组间、时间、交互作用比较,差异有统计学意义(P<0.05);试验组患者术后6 h内恶心呕吐、胸腔积液、肺部感染、肺不张和低体温的发生率低于对照组,差异有统计学意义(P<0.05);试验组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论胸腔镜下肺叶切除术实施加速康复外科多模式麻醉管理策略有利于患者术后疼痛程度减轻、术后并发症发生率减少、住院时间缩短,有利于患者术后快速康复。
Objective To explore the clinical effect of multi-mode anesthesia management based on the concept of enhanced recovery after surgery in the perioperative period of thoracoscopic lobectomy.Methods A total of 60 patients undergoing thoracoscopic lobectomy admitted to Ganzhou Municipal Hospital from April 2021 to March 2023 were selected as the research objects,and they were divided into experimental group(30 cases)and control group(30 cases)according to random number table method.The control group was treated with routine treatment,and the experimental group was treated with enhanced recovery after surgery.The time of thoracic drainage tube removal,the time of getting out of bed,the time of first anal exhaust and the average length of hospital stay were compared between the two groups.Resting visual analogue scale(VAS)scores were compared between the two groups at 6,12,24,48 and 72 h after surgery,and complications such as nausea and vomiting,pleural effusion,pulmonary infection,attasis and hypothermia within 6 h after surgery were compared between the two groups.Results The time of thoracic drainage tube removal,the time of getting out of bed,the time of first anal exhaust and the average length of hospital stay in the experimental group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The resting VAS scores of experimental group at 6,12,24 and 48 h after operation were lower than those of control group,and the differences were statistically significant(P<0.05).There was no significant difference in resting VAS score between the two groups at 72 h after surgery(P>0.05).The overall analysis results showed that there were statistically significant differences between groups,time and interaction of resting VAS scores at 6,12,24,48 and 72 h after surgery(P<0.05).The incidences of nausea and vomiting,pleural effusion,pulmonary infection,atelectasis and hypothermia within 6 h after operation in test group were lower than those in control group,and the differences we
作者
黄重峰
刘毅
程小玲
焦丰
吴文鴶
李铨华
HUANG Chongfeng;LIU Yi;CHENG Xiaoling;JIAO Feng;WU Wenjia;LI Quanhua(Department of Anesthesiology,Ganzhou Municipal Hospital,Jiangxi Province,Ganzhu341000,China)
出处
《中国当代医药》
CAS
2023年第32期106-109,113,共5页
China Modern Medicine
基金
江西省赣州市章贡区科技计划项目(区科字【2021】14号)。
关键词
加速康复外科
多模式麻醉管理
胸腔镜肺叶切除术
临床效果
Enhanced recovery after surgery
Multi-mode anesthesia management
Thoracoscopic lobectomy
Clinical effect
