张翔　谢德耀　陈朝红　林静静

[摘要] 目的 探讨快速康复外科理念（rapid rehabilitation surgery concept，FTS）对胸腔镜下肺癌根治术围手术期的影响。 方法 随机选取2015年5月～2017年5月我院收治的非小细胞肺癌患者100例，依据围术期处理方法将这些患者分为实验组（n=50）和对照组（n=50）两组，对照组患者给予常规的胸科物理治疗，实验组在常规胸科物理治疗基础上应用主动呼吸循环技术进行训练，然后对两组患者的VAS评分、胸腔闭式引流管、尿管的放置时间及术后住院时间、6MWT、SF-36评分、呼吸系统并发症发生情况进行统计分析。 结果 实验组患者的VAS评分均显著低于对照组（P<0.05），胸腔闭式引流管、尿管的放置时间及术后住院天数均显著短于对照组（P<0.05），6MWT显著长于对照组（P<0.05），呼吸系统并发症发生率4.0%（2/50）显著低于对照组18.0%（9/50）（P<0.05），SF-36量表中生理质量、角色质量、心理質量、社会质量评分均显著高于对照组（P<0.05）。 结论 快速康复外科理念能够有效改善胸腔镜下肺癌根治术围手术期护理效果。

[关键词] 快速康复外科理念；胸腔镜下肺癌根治术；围手术期

[中图分类号] R473.73；R655 [文献标识码] B [文章编号] 1673-9701（2017）36-0105-04

[Abstract] Objective To investigate the effect of rapid rehabilitation surgery concept（FTS）on the perioperative period of thoracoscopic lung cancer radical surgery. Methods 100 patients with non-small cell lung cancer who were admitted to our hospital from May 2015 to May 2017 were randomly selected. According to perioperative management， these patients were divided into experimental group（n=50） and control group（n=50）. Patients in the control group were given routine thoracic physical therapy. The experimental group was given active breathing cycle technical training on the basis of routine thoracic physical therapy. VAS score， closed thoracic drainage tube， catheter placement time and postoperative hospital stay， 6MWT， SF-36 score and occurrence of respiratory complications were analyzed statistically in both groups. Results The VAS score in the experimental group was significantly lower than that in the control group（P<0.05）. Closed thoracic drainage tube， catheter placement time and postoperative length of stay were significantly shorter than those in the control group（P<0.05）. 6MWT was significantly longer than the control group（P<0.05）. The incidence rate of respiratory complications was 4.0% （2/50）， significantly lower than that of 18.0%（9/50）in the control group（P<0.05）. In SF-36 scale， physical quality， role quality， psychological quality， and social quality scores were all significantly higher than those in the control group（P<0.05）. Conclusion The concept of rapid rehabilitation surgery can effectively improve the perioperative nursing effect of thoracoscopic lung cancer radical surgery.

[Key words] Rapid rehabilitation surgery concept（FTS）； Thoracoscopic lung cancer radical surgery； Perioperative period

FTS近5年来在欧美国家广泛应用，但主要应用中普通外科及妇科简单手术病人中。随着近几年术后快速康复的推进，胸腔镜技术的快速发展，加速康复外科（accelerated rehabilitation surgery，ERAS）运用于胸部手术围手术期以降低呼吸系统并发症。但到目前为止该技术并未普遍开展，对围手术期治疗运用的报道文献并不多[1]。本研究对2015年5月～2017年5月我院收治的非小细胞肺癌患者100例的临床资料进行统计分析，探讨快速康复外科理念对胸腔镜下肺癌根治术围手术期的影响，现报道如下。

1 资料与方法

1.1 一般资料

随机选取2015年5月～2017年5月我院收治的非小细胞肺癌患者100例，纳入标准：所有患者均经病理检查确诊为非小细胞肺癌，均有手术指征，均接受胸腔镜下肺癌根治术治疗；排除标准：将术中全肺切除等患者排除在外。……