Background: Lung cancer is currently the leading malignant tumor in both domestic and foreign morbidity and mortality. Surgical treatment is the main treatment option for lung cancer. The aim of this study is to explore the effects of enhanced recovery after surgery (ERAS) combined with respiratory function exercise combined with single-hole thoracoscopic surgery on lung cancer patients with postoperative pulmonary complications, postoperative pain, time to get out of bed, time to extubation and length of hospital stay.
Methods: A total of 240 patients who underwent endoscopic lung cancer surgery at the Affiliated Hospital of Yangzhou University and the Yancheng First People's Hospital from October 2017 to October 2019 were randomly divided into 4 groups, with 60 patients in each group. Patients in group A underwent single-hole thoracoscopic surgery, and preoperatively performed ERAS concept education and respiratory function training; group B used conventional 3-hole thoracoscopic surgery, and performed ERAS concept education and respiratory function training before operation; group C used conventional 3-hole thoracoscopic operation surgery, routine hospitalization education and nursing guidance, routine respiratory function training, no preoperative ERAS concept education; group D used single-hole thoracoscopic surgery, routine hospitalization education and nursing guidance, routine respiratory function training, no preoperative ERAS concept mission. The number of postoperative pulmonary complications, postoperative pain, time to get out of bed, extubation time, and hospital stay were recorded in the four groups.
Results: Compared with the groups B, C, and D, the incidence of pulmonary complications was significantly reduced, and the time to get out of bed, extubation time, and hospital stay were significantly shortened in group A. Compared with groups B, C, the postoperative pain was significantly reduced in group A. Compared with group C, the pulmonary complications were significantly reduced, and the time to get out of bed, extubation time and hospital stay were significantly shortened in group B. The differences were statistically significant (P<0.05). There was no significant difference in postoperative pain between group A and group D, group B and group C (P>0.05).
Conclusions: For patients with single-hole thoracoscopic lung cancer surgery, the ERAS concept guidance can effectively reduce the incidence of pulmonary complications and postoperative pain, shorten the time to get out of bed, the time to extubate, and the length of hospital stay.
【中文题目：单孔胸腔镜手术联合ERAS理念指导下的 呼吸功能锻炼在肺癌围手术期的应用】 【中文摘要：背景和目的 肺癌是当前国内和国外发病率和死亡率均排名前列的恶性肿瘤，手术治疗为肺癌治疗的主要治疗方案。本研究旨在探讨快速康复外科（enhanced recovery after surgery, ERAS）理念的呼吸功能锻炼联合单孔胸腔镜手术对肺癌患者术后肺部并发症、术后疼痛、下床时间、拔管时间以及住院时间的影响。方法 选择2017年10月-2019年10月在扬州大学附属医院和盐城市第一人民医院行胸腔镜肺癌手术的240例患者，随机分为四组，每组60例。A组患者采用单孔胸腔镜手术，术前进行ERAS理念宣教和呼吸功能锻炼；B组采用常规3孔胸腔镜手术，术前进行ERAS理念宣教和呼吸功能锻炼；C组采用常规3孔胸腔镜手术，进行常规入院宣教和护理指导，常规的呼吸功能锻炼，无术前ERAS理念宣教；D组采用单孔胸腔镜手术，进行常规入院宣教和护理指导以及常规的呼吸功能锻炼，无术前ERAS理念宣教。记录四组患者术后肺部并发症的发生数量、术后疼痛、下次时间、拔管时间及住院时间。结果 A组分别与B组、C组、D组三组比较，肺部并发症发生率明显降低，下床时间、拔管时间和住院时间明显缩短；与B组、C组两组比较，术后疼痛明显减轻；B组与C组比较，B组肺部并发症显著降低，下床时间、拔管时间和住院时间明显缩短，差异均有统计学意义（P<0.05）。术后疼痛在A组和D组比较以及B组和C组比较中均未见明显差异（P>0.05）。结论 对于单孔胸腔镜肺癌手术患者，ERAS理念指导可有效降低肺部并发症的发生率和术后疼痛，缩短下床时间、拔管时间以及住院时间。】 【中文关键词：肺肿瘤；快速康复外科；单孔胸腔镜手术】.
Keywords: Enhanced recovery after surgery; Lung neoplasms; Single-hole thoracoscopic surgery.