快速康复在肺癌手术患者护理中的应用研究.docVIP

快速康复在肺癌手术患者护理中的应用研究 [中图分类号] R734.2 [文献标识码] B [文章编号] 1673-9701（2016）12-0145-04　　Effect of fast track surgery on perioperative patients with lung cancer　　ZHANG Lanying TANG Chengwu FENG Wenming　　Department of Surgery， the First Peoples Hospital Affiliated to Huzhou University Medical College， Huzhou 313000，China　　[Abstract] Objective To investigate the effect of fast track surgery on perioperative patients with lung cancer. Methods Medical documents of 75 patients with lung cancer during May 2011 and May 2014 were retrospectively analyzed. Patients were divided into fast track surgery group （n=38） and control group （n=37）. The patients in the FTS group were treated following the fast track surgery principles and the patients in the control group received routine therapy. Operation time，anaesthesia time，chest tube indwelling time， pain degree， complications， hospital stay，initial hospitalization expense and initiation of chemotherapy were analyzed. Results No perioperative mortality was observed. FTS group was found to have shorter anaesthesia time[（198.2±25.7）min vs （221.8±22.4）min，P=0.0001]， chest tube indwelling time[（3.1±1.1）d vs （5.2±1.5）d，P=0.0000]， hospital stay[（10.5±2.8）d vs （14.7±3.4）d，P=0.0000） and less initial hospitalization expense [（2.6±0.8）million yuan vs （3.1±0.7）million yuan，P=0.0053）；Less pulmonary atelectasis（2/38 vs 9/37，P=0.0197） and lower pain degree（P=0.0482） were found in FTS group. Chemotherapy was initialized earlier in FTS group[（15.5±3.7）d vs （22.4±4.5）d，P=0.0000]. Conclusion The fast track surgery can effectively speed up the patients’ rehabilitation， reduce complication and shorten hospital stay.　　[Key words] Lung cancer resection； Fast track surgery； Complication； Hospital stay　　肺癌是目前我国呼吸道常见的恶性肿瘤，手术仍是肺癌重要的治疗方法[1，2]。肺癌手术为开胸手术， 手术创伤大，患者对所患疾病恐惧心理重，担心手术是否成功，加之手术后留置各种引流管、引流袋及监护装置，对此患者更容易产生恐惧、焦虑、烦躁等心理。因此减轻手术引起的创伤和术后的应激状态、降低围手术期并发症的发生率、加快患者术后康复并改善患者生存时间和长期生存质量仍然是我们当前需要解决的重大议题。快速康复外科理念（fast track surgery，FTS）又称“加速康复外科”，是指为了降低术后并发症的发生率和死亡率、加快患者术后