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围手术期 ERAS 理念在老年肺癌手术患者中的应用。

Application on perioperative ERAS concept in elderly lung cancer patients undergoing surgery.

机构信息

Department of Thoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China.

出版信息

Medicine (Baltimore). 2024 Feb 9;103(6):e36929. doi: 10.1097/MD.0000000000036929.

Abstract

Investigating the applying effects of the enhanced recovery after surgery (ERAS) in the perioperative period of elderly lung cancer patients undergoing the surgery. We randomly selected 98 elderly patients with lung cancer who were admitted to our hospital and underwent surgery from January 2022 to September 2023 as study subjects. The control group received conventional care during the perioperative period, and the intervention group received ERAS-guided care measures. The differences in perioperative-related indices, pulmonary function, pain level, inflammatory factors, and postoperative complication rates between these 2 groups were compared. The postoperative extubation time, the activity time since getting out of bad and hospital stay were lower in the observation group than those in the control group (P  < .05). At 3 days postoperatively, the FEV1, forced vital capacity and maximum ventilation volume of these 2 groups were lower than those of their same groups before surgery, and those of the observation group were higher than those of the control group (P  < .05). At 3 days postoperatively, the numerical rating scale in both groups were lower than those of their same groups at 6 hours postoperatively, and the numerical rating scale of the observation group was lower than that of the control group (P  < .05). At 3 days postoperatively, tumor necrosis factor-α, IL-6, and CRP in both groups were higher than those in their same groups before surgery, and those of the observation group was lower than those of the control group (P  < .05). The incidence of postoperative complications in the observation group was lower than that in the control group (P  < .05). ERAS applied in the perioperative period of elderly lung cancer patients undergoing surgery can shorten the hospital stay, promote the postoperative recovery on pulmonary function, alleviate inflammation, and reduce the risk of postoperative complications.

摘要

探讨加速康复外科(ERAS)在老年肺癌患者围手术期的应用效果。我们随机选取 2022 年 1 月至 2023 年 9 月期间在我院接受手术治疗的 98 例老年肺癌患者作为研究对象。对照组患者围手术期接受常规护理,观察组患者接受 ERAS 指导下的护理措施。比较两组患者围手术期相关指标、肺功能、疼痛程度、炎症因子及术后并发症发生率的差异。观察组患者术后拔管时间、下床活动时间及住院时间均低于对照组(P<0.05)。术后 3d 时,两组患者的 FEV1、用力肺活量及最大通气量均低于同组术前,且观察组高于对照组(P<0.05)。术后 3d 时,两组患者的数字评分量表均低于同组术后 6h,且观察组低于对照组(P<0.05)。术后 3d 时,两组患者的肿瘤坏死因子-α、IL-6 及 CRP 均高于同组术前,且观察组低于对照组(P<0.05)。观察组患者术后并发症发生率低于对照组(P<0.05)。ERAS 应用于老年肺癌患者围手术期可缩短住院时间,促进术后肺功能恢复,减轻炎症反应,降低术后并发症风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ed3/10860964/809412a18cc0/medi-103-e36929-g001.jpg

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