Effect of Combined Intervention of Thoracic Surgery and Rehabilitation Department on Fast Track Surgery of Patients after Uniportal Video-assisted Thoracoscopic Surgery
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摘要:
目的 探讨胸外科及康复科联合干预对单孔胸腔镜肺术后快速康复外科中的优势及应用价值。 方法 选取安宁市第一人民医院单孔胸腔镜下肺手术（包括肺楔形切除、肺段切除术及肺叶切除术）患者分为2组， 2020年2月至2021年2月的105例患者为对照组（术后常规胸外科处理组），2021年3月至2021年12月125例患者为研究组（术后胸外科联合康复科处理组），收集患者的手术数据、住院资料以及护理相关数据。比较2组患者术后住院时间、术后疼痛视觉模拟评分法（visual analoguescales，VAS）评分、患者满意度等方面的差别。 结果 研究组术后住院时间，低于对照组，且差异有统计学意义（P < 0.05），术后24 h、术后48 h VAS评分，低于对照组，且差异有统计学意义（ P < 0.05），术后72 h VAS评分，低于对照组，差异无统计学意义（ P > 0.05）。满意度高于对照组，且差异有统计学意义（ P < 0.05）。 结论 胸外科及康复科联合干预对单孔胸腔镜肺术后，能进一步减轻疼痛、减少镇痛药物用量、缩短术后住院时间。在快速康复外科理念下，胸外科及康复科联合干预对单孔胸腔镜肺术后显著的优势，值得临床推广应用。 Abstract:Objective To explore the advantages and application value of combined intervention of thoracic surgery and rehabilitation department in fast track surgery after uniportal video-assisted thoracoscopic surgery. Methods Patients who underwent uniportal video-assisted thoracoscopic surgery（including lung wedge resection, segmentectomy, and lobectomy） in the Anning First People’s Hospital was divided into two groups. From February 2020 to February 2021, 105 patients were in the control group（postoperative routine thoracic surgery treatment）, 125 patients from March 2021 to December 2021 were in the research group（postoperative thoracic surgery combined with rehabilitation department treatment group）, and the surgical data, hospitalization data, and nursing-related data of the patients were collected. The differences in postoperative hospital stay, postoperative pain visual analog scales（VAS） scores, and patient satisfaction were compared between the two groups. Results The postoperative hospital stay time of the study group was lower than that of the control group, and the difference was statistically significant（P < 0.05）, and the VAS score at 24h and 48h after the operation were lower than that of the control group, and the difference was statistically significant（ P < 0.05）, 72h VAS score after the operation, lower than the control group, the difference was not statistically significant（ P > 0.05）. Satisfaction was higher than that of the control group, and the difference was statistically significant（ P < 0.05）. Conclusions The combined intervention of thoracic surgery and rehabilitation department can further relieve pain, reduce the dosage of analgesic drugs, and shorten the postoperative hospital stay after uniportal video-assisted thoracoscopic surgery. Under the concept of fast-track surgery, the combined intervention of thoracic surgery and rehabilitation department has significant advantages in uniportal video-assisted thoracoscopic surgery, which is worthy of clinical application. -
表 1 患者一般资料的比较[
$ \bar x \pm s $ /n（%）]Table 1. Comparison of general data of patients[
$ \bar x \pm s $ /n（%）]项目 对照组（105） 研究组（125） t/χ2 P 年龄（岁） 54.61±11.74 53.91±11.26 0.459 0.647 性别 0.723 0.395 男 29 41 女 76 84 肿瘤类型 0.111 0.946 腺癌 85 99 鳞癌 17 22 其他 3 4 切除类型 0.179 0.914 肺楔形切 42 47 肺段切除 28 36 肺叶切除 35 42 TNM分期 0.806 0.668 Ⅰ期 90 102 Ⅱ期 7 12 Ⅲ期 8 11 
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表 2 患者术后疼痛情况的比较（
$ \bar x \pm s $ ）Table 2. Comparison of postoperative pain of patients（
$ \bar x \pm s $ ）项目 对照组 研究组 t P 术后疼痛评分 术后24 h 4.88 ± 0.63 4.01 ± 0.74 9.639 < 0.001* 术后48 h 3.94 ± 0.39 3.31 ± 0.68 8.452 < 0.001* 术后72 h 2.57 ± 0.57 2.45 ± 0.50 1.751 0.081 *P < 0.05。
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表 3 患者术后住院天数的比较（
$ \bar x \pm s $ ）Table 3. Comparison of postoperative hospital stay （
$ \bar x \pm s $ ）资料 对照组 研究组 t P 术后住院时间（d） 5.15 ± 1.20 4.08 ± 1.05 −7.244 < 0.001* *P < 0.05。
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表 4 患者护理满意度的比较（
$ \bar x \pm s $ ）Table 4. Comparison of patients' nursing satisfaction （
$ \bar x \pm s $ ）项目 对照组 研究组 t P 满意度 93. 0 ± 1.34 95. 45 ± 1.84 −11.588 < 0.001* *P < 0.05。
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