Wang Zhihai, Lin Miaomiao, Geng Geng, Wu Weiwei, Tao Yong
Department of Thoracic and Cardiovascular Surgery, Wuhu Hospital Affiliated to East China Normal University (Wuhu No. 2 People's Hospital), Wuhu, Anhui, China. (Drs. Wang, Geng, Wu, and Tao).
Wannan Medical College, Wuhu, Anhui, China. (Dr. Lin).
JSLS. 2024 Jul-Sep;28(3). doi: 10.4293/JSLS.2024.00037. Epub 2025 Jan 10.
To explore a model suitable for enhanced recovery after surgery (ERAS) for elderly patients with lung cancer in this region.
A total of 200 elderly patients with lung cancer who were admitted to our department and received thoracoscopic surgery from January 1, 2020, to December 31, 2021, were enrolled as observation subjects and were randomly assigned to an ERAS group (100 cases) and a control group (100 cases). All patients were aware of and agreed to enter the study, and the protocols were approved by the hospital ethics committee (2021 Medical Ethics Review 26). The incidence of postoperative pulmonary complications, duration of postoperative chest tube, postoperative pain, and pulmonary function (including forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1)) on postoperative day 7 were compared between the 2 groups.
The incidence of postoperative pulmonary complications was significantly lower in the ERAS group (8.00%) than in the control group (18.00%). The incidence of postoperative atelectasis in the ERAS group (2%) was significantly lower than that in the control group (10%). The duration of postoperative chest tube in the ERAS group (2.57 ± 0.72 days) was significantly shorter than that in the control group (3.92 ± 1.54 days). The postoperative pain score of the ERAS group (2.14 ± 0.86) was significantly lower than that of the control group (3.78 ± 1.15). On postoperative day 7, both FVC and FEV1 in the ERAS group were significantly better than those in the control group. SPSS 20 was used for statistical analysis, and the < .05 was considered clinically significant.
The ERAS model established in our department can reduce the incidence of postoperative complications, relieve postoperative pain, and better protect the lung function of elderly patients with lung cancer. The model is worth promoting because it enhances recovery after surgery and reduces the family burden of patients.
探索适合本地区老年肺癌患者的术后加速康复（ERAS）模式。
选取2020年1月1日至2021年12月31日期间入住我科并接受胸腔镜手术的200例老年肺癌患者作为观察对象，随机分为ERAS组（100例）和对照组（100例）。所有患者均知晓并同意进入本研究，研究方案经医院伦理委员会批准（2021医学伦理审查26号）。比较两组患者术后肺部并发症发生率、术后胸管留置时间、术后疼痛情况及术后第7天的肺功能（包括用力肺活量（FVC）和第1秒用力呼气量（FEV1））。
ERAS组术后肺部并发症发生率（8.00%）显著低于对照组（18.00%）。ERAS组术后肺不张发生率（2%）显著低于对照组（10%）。ERAS组术后胸管留置时间（2.57±0.72天）显著短于对照组（3.92±1.54天）。ERAS组术后疼痛评分（2.14±0.86）显著低于对照组（3.78±1.15）。术后第7天，ERAS组的FVC和FEV1均显著优于对照组。采用SPSS 20进行统计分析，P<0.05为差异有统计学意义。
我科建立的ERAS模式可降低老年肺癌患者术后并发症发生率，减轻术后疼痛，更好地保护患者肺功能。该模式有助于促进术后康复，减轻患者家庭负担，值得推广。
