Effect of influence of nursing intervention under the guidance of the concept of fast track surgery on the stress response and rehabilitation effect of thoracoscopic pulmonary nodule resection
WENG Yun CHEN Jinxiu JIANG Ji
Department of Thoracic Surgery, the Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, Jiangsu Province, Huai’an 223300, China
Abstract：Objective To investigate the effect of nursing intervention based on the concept of fast track surgery on the stress response and rehabilitation effect of patients undergoing thoracoscopic pulmonary nodule resection. Methods A total of 92 patients undergoing thoracoscopic pulmonary nodule resection in the Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University were selected. According to the operation time, they were divided into 48 cases in the treatment group (October 2018—May 2019) and 44 cases in the control group (February 2018—September 2018). The control group was given routine nursing intervention, and the treatment group was given nursing intervention based on the concept of fast track surgery. The stress response, operation-related indicators, and complications were compared between the two groups. Results After 72 h operation, the heart rates of the two groups were lower than those before the operation, Interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) were all higher than those before the operation (P ＜ 0.01). The heart rate of the treatment group was significantly higher than that of the control group, and IL-6, TNF-α, CRP were significantly lower than the control group (P ＜ 0.01). There was no significant difference in operation time between the two groups of patients (P ＞ 0.05). The amount of intraoperative fluid infusion, the time to remove the tracheal tube, the time to remove the chest drainage tube, and the length of stay were significantly shorter than those of the control group (P ＜ 0.01). The incidence of complications was significantly lower than that of the control group (P ＜ 0.05). Conclusion Nursing intervention based on the concept of fast track surgery can help relieve the stress response of patients undergoing thoracoscopic pulmonary nodule resection, promote postoperative recovery, and reduce complications.
翁芸 陈金秀 江吉. 基于快速康复外科理念指导下的护理干预对胸腔镜肺结节切除术患者应激反应及康复效果的影响[J]. 中国医药导报, 2020, 17(34): 177-180.
WENG Yun CHEN Jinxiu JIANG Ji. Effect of influence of nursing intervention under the guidance of the concept of fast track surgery on the stress response and rehabilitation effect of thoracoscopic pulmonary nodule resection. 中国医药导报, 2020, 17(34): 177-180.
[1] Maalioune S，Corhay JL，Delvenne P，et al. Sarcoidosis following tuberculosis. Is there a link between these granulomatous diseases? [J]. Rev Med Liege，2019，74（7/8）：394-400.
[2] 曾德更，符莉莉，黄淑芳，等.CT引导下微弹簧圈定位技术在电视胸腔镜外科手术切除孤立性肺结节中的临床应用价值[J].中国医学前沿杂志：电子版，2019，11（3）：149-152.
[3] Bardet J，Zaimi R，Dakhil B，et al. Outpatient thoracoscopic resection of lung nodules within a fast-track recovery program [J]. Rev Mal Respir，2016，33（5）：343-349.
[4] 张爱珍，李静.优质护理在CT引导钢针定位肺结节胸腔镜手术围术期应用的效果评价[J].影响研究与医学应用，2018，2（11）：127-128.
[5] Scardino M，D’Amato T，Martorelli F，et al. Sublingual sufentanil tablet system Zalviso for postoperative analgesia after knee replacement in fast track surgery：a pilot observational study [J]. J Exp Orthop，2018，20（1）：8.
[6] 中国加速康复外科专家组.中国加速康复外科围手术期管理专家共识[J].中华外科杂志，2016，54（1）：413-418.
[7] 中华医学会呼吸病学分会肺癌学组.中国肺癌防治联盟专家组.肺部结节诊治中国专家共识[J].中华结核和呼吸杂志，2015，38（4）：249-254.
[8] Fukui Y，Kohno T，Fujimori S，et al. Three-port thoraco scopic middle lobectomy in a patient after left pneumonectomy [J]. Ann Thorac Surg，2015，99（4）：1422-1425.
[9] 王哲敏，范绒丽，顾美华，等.患者版图文式临床护理路径在胸腔镜肺结节切除术患者中的应用[J].现代中西医结合杂志，2017，26（24）：2727-2730.
[10] Holbek BL，Horsleben Peteresen R，Kehlet H，et al. Fast-track video-assisted thoracoscopic surgery：future challenges [J]. Scand Cardiovasc J，2016，50（2）：78-82.
[11] Dean M，Ramsay R，Heriot A，et al. Warmed，humidified CO2 insufflation benefits intraoperative core temperature during laparoscopic surgery：A meta-analysis [J]. Asian J Endosc Surg，2017，10（2）：128-136.
[12] 杨洋，徐耕，隋铁泉.双细管引流在单孔腹腔镜治疗低龄原发性自发性气胸患者术后快速康复中的应用[J].中华胸心血管外科杂志，2019，35（1）：10-13.
[13] 程璞，卢召，张明光，等.腹腔镜辅助结直肠癌手术联合加速康复外科处理的近期疗效分析[J].中华普通外科杂志，2019，34（3）：204-207.
[14] 陈佩军，何海平，陈燕，等.优化麻醉管理在胸腔镜肺部小结节手术患者加速康复外科的应用[J].江苏医药，2018，44（4）：422-425.
[15] 沙永生，孔轻轻.快速康复外科理念在肺癌患者护理应用中的效果评价[J].护士进修杂志，2017，32（21）：1963-1965.
[16] Goldhammer JE，Dashiell JM，Davis S，et al. Use of Provider Debriefing to Improve Fast-Track Extubation Rates Following Cardiac Surgery at an Academic Medical Center [J]. Am J Med Qual，2018，33（2）：172-176.
[17] 张红红，叶运廷，温静兰，等.基于循证的多学科合作快速康复外科护理模式在腹部肿瘤手术病人中的应用[J].循证护理，2018，4（3）：250-254.
[18] Crippa J，Mari GM，Miranda A，et al. Surgical Stress Response and Enhanced Recovery after Laparoscopic Surgery - A systematic review [J]. Chirurgia （Bucur），2018， 113（4）：455-463.
[19] 梁玉胜.快速康复外科理论在电视胸腔镜肺叶切除术患者中的应用效果[J].中国临床护理，2018，10（3）：225-227.
[20] Maria K，Evangelos KA，Dimitris KP，et al. Postoperative stress and pain response applying fast-track protocol in patients undergoing hepatectomy [J]. J Perioper Pract，2018，12：1750458918812293.
[21] 乔坤，彭彬，黄代强，等.加速康复外科联合全胸腔镜在肺癌病人根治术中的应用研究[J].肠外与肠内营养，2016，23（2）：99-102.
[22] 吕卓辰，熊晨君，严佶祺，等.实施加速康复外科麻醉管理对甲状腺手术应激水平的影响[J].临床麻醉学杂志，2017，33（8）：733-737.
[23] 杨燕萍，沈梅芬.复合保温对全髋关节置换老年患者术中低体温的影响研究[J].护士进修杂志，2017，32（1）：78-80.
[24] 蔺建华，王纪明，许会玲，等.不同术中保温对胃肠术患者体温与凝血功能及手术部位感染的影响[J].中华医院感染学杂志，2016，26（18）：4176-4178.
[25] 孙宗琪，吴先群，蔡成章.老年腹部肿瘤患者术后医院感染的危险因素及预防措施[J].中国肿瘤临床与康复，2018，25（11）：1354-1356.
[26] 刘九思，谢斌，石世代.快速康复外科理念联合腹腔镜技术在结直肠癌手术中的应用[J].当代医学，2019，25（29）：37-40.
[27] 侯慧，顾则娟，陈丽.胃癌术后腹腔感染早期预警评分的构建及临床应用[J].现代消化及介入诊疗，2018（A01）：19-20.
[28] 陈燕，彭伟.细胞免疫功能和炎性因子在结直肠癌患者根治术后并发切口感染中的价值研究[J].现代消化及介入诊疗，2019，24（2）：158-161.
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