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肺癌手术患者术后加速康复的最佳证据总结

Summary of best evidence for enhanced recovery after surgery for patients undergoing lung cancer operations.

作者信息

Lu Yutong, Yuan Zhenwei, Han Yuqiang, Zhang Yanfang, Xu Renhua

机构信息

School of Nursing, Binzhou Medical University, Yantai, Shandong, China.

Library, Binzhou Medical University, Yantai, Shandong, China.

出版信息

Asia Pac J Oncol Nurs. 2022 Mar 26;9(7):100054. doi: 10.1016/j.apjon.2022.03.006. eCollection 2022 Jul.

Abstract

According to the cancer burden report released by the International Agency for Research on Cancer (IARC) in 2020, the mortality rate of lung cancer is 18%, ranking first in the world, and its morbidity and mortality rates are highest in China. Pneumonectomy is the preferred treatment for lung cancer patients, but surgery carries a significant risk of perioperative complications, which may affect the patient's functional recovery and quality of life. So, the rehabilitation of the large number of lung cancer patients in China requires greater attention. A number of studies have shown that the enhanced recovery after surgery (ERAS) protocol can reduce the risk of death, readmission rate, adjuvant chemotherapy time, postoperative pain level, anesthesia medication amount, length of stay, and hospitalization expenses. Foreign literature has successively issued guidelines to improve recovery among lung cancer patients, but Chinese-specific literature for patients undergoing lung cancer surgery or thoracic surgery remains inadequate. Some Chinese expert consensus have only considered part of the content of ERAS in thoracic surgery. To summary the evidence of the ERAS program for lung cancer surgery patients at home and abroad basing on evidence-based medicine is necessary. Therefore, this study used evidence-based practical thinking as a guide to (1) evaluate, integrate, and summarize relevant evidence guidelines and data resources at home and abroad so as to construct an enhanced recovery program for lung cancer patients suitable for Chinese national conditions and (2) provide a scientific basis for future research and practice in related fields.

摘要

根据国际癌症研究机构(IARC)2020年发布的癌症负担报告,肺癌死亡率为18%,位居全球之首,在中国其发病率和死亡率也最高。肺切除术是肺癌患者的首选治疗方法,但手术存在围手术期并发症的重大风险,这可能会影响患者的功能恢复和生活质量。因此,中国大量肺癌患者的康复需要更多关注。多项研究表明,术后加速康复(ERAS)方案可降低死亡风险、再入院率、辅助化疗时间、术后疼痛程度、麻醉用药量、住院时间和住院费用。国外文献已相继发布改善肺癌患者康复的指南,但针对肺癌手术或胸外科手术患者的中文文献仍然不足。一些中国专家共识仅考虑了胸外科手术中ERAS的部分内容。基于循证医学总结国内外肺癌手术患者ERAS方案的证据很有必要。因此,本研究以循证实践思维为指导,(1)评估、整合和总结国内外相关证据指南和数据资源,以构建适合中国国情的肺癌患者加速康复方案;(2)为相关领域未来的研究和实践提供科学依据。

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