【摘要】 目的探讨快速康复外科(fast track surgery,FTS)在胸腔镜肺癌根治术中的应用效果。方法选择2014年1月—2015年9月在成都医学院第一附属医院接受胸腔镜肺癌根治术的肺癌160例,采用随机数字表法随机将其分为观察组和对照组各80例,观察组行胸腔镜肺癌根治术联合FTS治疗,对照组行胸腔镜肺癌根治术治疗,观察比较两组手术相关指标、术前及术后3 d外周血免疫因子水平以及术后并发症发生情况。结果观察组术后拔管时间、下床活动时间、术后3 d视觉模拟评分得分、术后住院时间及住院费用均低于对照组,两组比较差异有统计学意义(P>0.05)。术后3 d,两组肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)及白细胞介素10(IL-10)水平均明显高于术前,差异均有统计学意义(P<0.05);观察组TNF-α及IL-6水平均低于对照组,IL-10水平高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为10.00%明显低于对照组术后并发症发生率37.50%,两组比较差异有统计学意义(P<0.05)。结论 FTS应用于胸腔镜肺癌根治术可改善患者手术相关指标,提高患者免疫功能,降低术后并发症发生率。更多还原

【Abstract】 Objective To investigate effects of fast rehabilitation surgery(FRS) in application of radical operation for lung cancer under thoracoscope. Methods A total of 160 patients with lung cancer undergoing radical operation for lung cancer under thoracoscope during January 2014 and September 2015 were divided into observation group( n = 80) and control group( n = 80) according to the random number table. Observation group was treated with radical operation for lung cancer under thoracoscope combined with FRS,while control group was treated with radical operation for lung cancer under thoracoscope only. Postoperative indicators,levels of immunologic factors before operation and 3 d after operation and postoperative incidence rate of complications were observed and compared in two groups. Results Values of postoperative extubation time,off-bed activity time,visual analogue scales( VAS) score on postoperative 3rdd,postoperative length of stay and hospitalization costs in observation group were lower than those in control group( P > 0. 05). On postoperative 3rdd,levels of tumor necrosis factor-α( TNF-α),interleukin-6( IL-6) and IL-10 were significantly higher than those before operation in two groups(P < 0. 05); TNF-α and IL-6 levels were significantly lower,while IL-10 level was significantly higher in observation group than those in control group( P < 0. 05). Incidence rate of postoperative complications in observation group( 10. 00%) was significantly lower 37. 50% in control group( P < 0. 05). Conclusion FRS in application of radical operation for lung cancer under thoracoscope can effectively improve the postoperative indicators,improve immunological function and reduce incidence rate of postoperative complications.更多还原