中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2011年
1期
38-40
,共3页
汪进益%陈国涵%洪暄%刘刚%李钦传%刘中民
汪進益%陳國涵%洪暄%劉剛%李欽傳%劉中民
왕진익%진국함%홍훤%류강%리흠전%류중민
康复/方法%癌,非小细胞肺/外科学/康复%手术后并发症%外科手术/方法%肺疾病/并发症
康複/方法%癌,非小細胞肺/外科學/康複%手術後併髮癥%外科手術/方法%肺疾病/併髮癥
강복/방법%암,비소세포폐/외과학/강복%수술후병발증%외과수술/방법%폐질병/병발증
Rehabilitation/MT%Carcinoma,non-small-cell lung/RH/SU%Postoperative complications%Surgical procedures,operative/MT%Lung diseases/CO
目的 对比研究快速康复外科(fast track surgery,FTS)和传统手术外科(conservative treatment surgery,CTS)对非小细胞肺癌(nonsmall-cell lung cancer,NSCLC)患者术后肺部并发症的发生率影响.方法 选取2008年01月至2010年05月在本科对40例非小细胞肺癌行肺叶切除术患者采用FTS治疗(FTS组);和同期40例按CTS围手术期处理的同种患者(CTS组)作对照.比较两组患者术后肺部并发症(肺部感染、肺不张、持续漏气＞7 d)的发生率;同时分析两组术后辅助通气时间、手术结束时体温、ICU停留时间以及住院时间等情况.结果 FTS组较CTS组术后肺部并发症的发生率显著减少(34.21%vs 8.33%,P＜0.05);两组ICU停留时间的中位数相差1天;FTS组住院天数较CTS组明显减少[(11.1±3.6)d vs(16.6±5.7)d,P＜0.01].结论 按照FTS原则对NSCLC患者进行手术治疗,选择合适的围手术期处理以减少术后肺部并发症的发生率,促进患者早期康复.
目的 對比研究快速康複外科(fast track surgery,FTS)和傳統手術外科(conservative treatment surgery,CTS)對非小細胞肺癌(nonsmall-cell lung cancer,NSCLC)患者術後肺部併髮癥的髮生率影響.方法 選取2008年01月至2010年05月在本科對40例非小細胞肺癌行肺葉切除術患者採用FTS治療(FTS組);和同期40例按CTS圍手術期處理的同種患者(CTS組)作對照.比較兩組患者術後肺部併髮癥(肺部感染、肺不張、持續漏氣＞7 d)的髮生率;同時分析兩組術後輔助通氣時間、手術結束時體溫、ICU停留時間以及住院時間等情況.結果 FTS組較CTS組術後肺部併髮癥的髮生率顯著減少(34.21%vs 8.33%,P＜0.05);兩組ICU停留時間的中位數相差1天;FTS組住院天數較CTS組明顯減少[(11.1±3.6)d vs(16.6±5.7)d,P＜0.01].結論 按照FTS原則對NSCLC患者進行手術治療,選擇閤適的圍手術期處理以減少術後肺部併髮癥的髮生率,促進患者早期康複.
목적 대비연구쾌속강복외과(fast track surgery,FTS)화전통수술외과(conservative treatment surgery,CTS)대비소세포폐암(nonsmall-cell lung cancer,NSCLC)환자술후폐부병발증적발생솔영향.방법 선취2008년01월지2010년05월재본과대40례비소세포폐암행폐협절제술환자채용FTS치료(FTS조);화동기40례안CTS위수술기처리적동충환자(CTS조)작대조.비교량조환자술후폐부병발증(폐부감염、폐불장、지속루기＞7 d)적발생솔;동시분석량조술후보조통기시간、수술결속시체온、ICU정류시간이급주원시간등정황.결과 FTS조교CTS조술후폐부병발증적발생솔현저감소(34.21%vs 8.33%,P＜0.05);량조ICU정류시간적중위수상차1천;FTS조주원천수교CTS조명현감소[(11.1±3.6)d vs(16.6±5.7)d,P＜0.01].결론 안조FTS원칙대NSCLC환자진행수술치료,선택합괄적위수술기처리이감소술후폐부병발증적발생솔,촉진환자조기강복.
Objective In a prospective randomized controlled pilot study, effects of postoperative pulmonary complications on a conservative treatment surgery (CTS) and fast track surgery (FTS) treatment regimen in non-small cell lung cancer (NSCLC) patients undergoing pulmonary lobectomy were compared.Methods Eighty patients who underwent radical pulmonary lobectomy surgical treatment for non-small cell lung cancer disease from January 2008 to May 2010 in our hospital were random assigned to either fast track surgery treatment (40 FTS group) or conservative treatment surgery regimen (40 CTS group). Study endpoints were pulmonary complications ( pneumonia, atelectasis, prolonged air leak ＞ 7 days); Further parameters assessed in the postoperative course of patients were the need for postoperative mechanical ventilation, temperature at the end of the operation, length of stay (LOS) on intensive care unit (ICU) and day of discharge. Results The rate of postoperative pulmonary complications was 34. 21% in CTS group and 8. 33% in FTS group ( P ＜0. 05). Median length of stay on ICU was comparable in both groups ( 1 day),but the day of discharge was significantly different in both groups [( 11. 1 ±3.6)d vs ( 16. 6 ±5.7)d, P ＜0. 01]. Conclusion Using this fast track clinical pathway, the rate of pulmonary complications could be significantly decreased as compared to a conservative treatment regimen. Our results supported the implementation of an optimized perioperative treatment in lung surgery for non-small cell lung cancer patients undergoing radical pulmonary in order to reduce pulmonary complications after major lung surgery.
