[1] LIN Shunyan YIN Zhenglu SUN Chao CHEN Bo GAO Wei,.Application of Rapid Rehabilitation Surgery with Chinese characteristics in Elderly Patients with Lung Cancer Undergoing Thoracoscopic Radical Surgery [J]. Modern Traditional Chinese Medicine, 2023, (01): 110-115. [doi: 10.13424/j.cnki.mtcm.2023.01.021]
Application of Rapid Rehabilitation Surgery with Chinese characteristics in Elderly Patients with Lung Cancer Undergoing Thoracoscopic Radical Surgery
- Article number:
- 1672-0571(2023)01-0110-06
- Keywords:
- TCM; Rapid rehabilitation surgery; Lung cancer; Thoracoscope; Lung function; Inflammatory cytokine
- ZTFLH:
- R273
- Code:
- A
- Abstract:
- Objective To construct a rapid rehabilitation surgery with Chinese characteristics (ERAS) and evaluate its safety and effectiveness in elderly patients with lung cancer undergoing thoracoscopic radical surgery.Methods From January 1，2018 to December 31，2020，the elderly patients with lung cancer who underwent thoracoscopic radical surgery in Subei Peoples Hospital were prospectively selected and divided into the control group and the treatment group by random number table.The patients in the control group received ERAS treatment during the perioperative period，and the patients in the treatment group received ERAS treatment with Chinese characteristics.Postoperative complications，pulmonary function before and 3 days after operation and peripheral serum interleukin1β(IL1β)，Interleukin10 (IL10)，tumor necrosis factorα (TNFα) were compared between the two groups .Results A total of 70 lung cancer patients met the inclusion criteria in this study，and 67 patients completed the study，including the control group (n=23) and the treatment group (n=34).The extubation time，ambulation time and hospitalization time of the control group were (5.31±1.17)，(3.14±1.02) and (8.69±1.37) days，respectively；The treatment group was (3.12±1.11)，(2.08±0.75) and (6.57±1.25) days，respectively.The indexes in the treatment group were better than those in the control group，with a statistically significant difference (P<0.05).There were 11 cases of complications in the control group (33.3%)，and 6 cases in the treatment group (17.6%).The incidence in the treatment group was lower than that in the control group，with a statistically significant difference (P<0.05).The pulmonary function indexes of the two groups decreased one day before discharge，with statistical significance (P<0.05).Compared with the control group，the treatment group was superior to the control group，with statistical significance (P<0.05).Three days after operation，all indexes of the two groups were higher than before，and the difference was statistically significant (P<0.05).Compared between groups，all indexes of the treatment group were lower than those of the control group，and the difference was statistically significant (P<0.05). Conclusion ERAS system with Chinese characteristics can reduce the complications of elderly patients with lung cancer after thoracoscopic radical surgery，which is conducive to the recovery of lung function and inhibits the release of early inflammatory factors.
References:
［1］Chen S,Zou Z,Chen F,et al.A meta-analysis of fast track surgery forpatients with gastric cancer undergoing gastrectomy［J］.Ann R Coll Surg Engl,2015,97(1):3-10.
［2］胥瑞婷，马音，朱炜炜.中医药联合靶向药物治疗非小细胞肺癌的研究进展［J］.现代中西医结合杂志，2020,29(12):113-117.
［3］Rusch V W,Chansky K,Kindler H L,et al.The IASLC Mesothelioma Staging Project：Proposals for the M Descriptors and for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Mesothelioma［J］.J Thorac Oncol,2016,11(12):2112-2119.
［4］Zhao JH,Sun JX,Huang XZ,et al.Meta-analysis of the laparoscopic versus open colorectal surgery within fast track surgery［J］.Nt J Colorectal Dis,2016,31(3):613-622.
［5］夏燕,常淑文,叶敬霆,等.快速康复外科在肺癌手术患者中应用效果的meta分析［J］.中国肺癌杂志,2016,19(12):827-836.
［6］夏燕,常淑文,叶敬霆,等.快速康复外科在肺癌手术患者中应用效果的meta分析［J］.中国肺癌杂志,2016,19(12):827-836.
［7］Asmussen S,Maybauer DM,Chen JD.et al.Effects of Acupuncture in Anesthesia for Craniotomy：A Meta-Analysis［J］.J Neurosurg Anesthesiol,2017,29(3):219-27.
［8］Wang SM,Peloquin C,Kain ZN.The use of auricular acupuncture to reduce preoperative anxiety［J］.Anesth Analg,2001,93(5):1178-1180.
［9］陶涛，陈婷，杨爱明，等.耳穴贴压辅助全麻对妇科腹腔 镜术后恶心呕吐发生率及镇痛效果影响的临床研究［J］.浙江中医药大学学报，2016,40（8）：632-635.
［10］林宣晨.耳穴压豆对妇科腹腔镜术后恶心呕吐及镇痛效果的影响［J］.浙江中西医结合杂志，2017（2）：144-146.
［11］张爽,甘建辉,涂青,等.经皮穴位电刺激对胸腔镜肺切除术病人拔管期应激反应的影响［J］.安徽医药,2020,24(7):1407-1411.
［12］Huang S,Peng W,Tian X,et al.Effects of transcutaneous electrical acupoint stimulation at different frequencies on perioperative anesthetic dosage,recovery,complications,and prognosis in video-assisted thoracic surgical lobectomy：a randomized,double-blinded,placebo-controlled trial［J］.J Anesth.2017,31(1):58-65.
［13］林舜艳,尹正录，高巨，等.电针对老年患者颈动脉内膜剥脱术后认知功能的影响［J］.中华麻醉学杂志,2016,36(9):1076-1079.
［14］姚琳，杨馥铭，刘雁泽，等．基于数据挖掘技术探析针刺治疗炎性痛临床选穴规律［J］．中国中医急症，2019,28(5)：782-785．
［15］张佩军，张庆，王建波.针刺及相关技术在围术期的应用［J］.中国中西医结合外科杂志,2015,21(4):437-438.
［16］卢静，张朝晖．耳针治疗乳腺癌术后相关症状的临床研究 现状和展望［J］．中国针灸，2018,38(11):1249-1254．
［17］莫辉胜，蓝育林，潘毓标，等.电视胸腔镜肺叶切除术对老年肺癌患者心肺功能与生存质量的影响［J］.中国老年学杂志，2018,38(6):1345-1347.
［18］李学军，王文林，王明智.胸腔镜微创手术对肺癌患者心肺功能的改善及免疫功能的影响［J］.解放军预防医学杂志，2019,37(7):3-4.
［19］孙宁，李东盼，孙岩.六字诀联合缩唇腹式呼吸训练对COPD稳定期患者肺功能及生活质量的影响［J］.医学临床研究，2019，36(5)：1003-1004.
Memo
基金项目：江苏省青年医学重点人才项目（QNRC2016336）；扬州市医学重点人才项目（201847）