正性同化护理联合多学科-快速康复链式管理在肺癌胸腔镜手术患者中的应用

doi:10.19983/j.issn.2096-8493.20250139

摘要/Abstract

摘要：

目的: 分析正性同化护理联合多学科-快速康复(MDT-ERAS)链式护理在肺癌胸腔镜手术患者中的应用效果。方法: 选择2024年1—12月于莆田学院附属医院行单孔胸腔镜肺叶切除术治疗的肺癌患者80例为研究对象,以抛硬币法实施分组管理,对照组(40例)接受MDT-ERAS链式护理,观察组(40例)于对照组基础上加用正性同化护理,对两组干预后的HHI评分、快速康复依从性好的比例、康复指标、术后肺部并发症发生率等观察指标进行比较。结果: 观察组HHI评分为(12.60±1.13)分、(12.53±0.99)分、(12.58±1.24)分,高于对照组[(9.25±1.13)分、(9.18±1.34)分、(10.35±0.86)分],差异均有统计学意义(t值分别为13.291、12.747、9.322,P值均<0.05)。观察组快速康复依从性好的比例为97.50%(39/40),高于对照组的80.00%(32/40),差异有统计学意义(χ²=6.135,P=0.013)。观察组首次离床活动时间、胸腔引流管留置时长、总住院时长、术后疼痛评分分别为(6.13±1.32)h、(22.60±1.50)h、(12.48±1.54)d、(2.83±1.13)分,低于对照组[(11.25±1.19)h、(27.38±2.07)h、(18.35±2.09)d、(4.33±1.12)分],差异均有统计学意义(t值分别为-18.187、-11.811、-14.306、-5.968,P值均<0.05);术后肺部并发症发生率为5.00%(2/40),与对照组[22.50%(9/40)]比较,差异无统计学意义(χ²=3.794,P>0.05)。结论: 采用正性同化护理联合MDT-ERAS链式护理对肺癌手术患者实施干预,可提升患者希望水平与快速康复依从性,实现安全快速康复目标。

关键词: 癌, 非小细胞肺, 康复护理, 对比研究

Abstract:

Objective: To analyze the effect of combining positive assimilation nursing with MDT-ERAS chain nursing on patients undergoing thoracoscopic lung resection for lung cancer. Methods: Eighty patients with lung cancer who underwent single-port thoracoscopic lobectomy at Putian University Affiliated Hospital from January to December 2024 were selected as the observation sample. The patients were randomly assigned to two groups by a coin toss. The control group (40 patients) received MDT-ERAS chain nursing, while the study group (40 patients) received MDT-ERAS chain nursing combined with positive assimilation nursing. After the intervention, the two groups’ HHI scores, rapid recovery compliance rates, rehabilitation indices, and postoperative pulmonary complication rates were compared. Results: The HHI scores in the study group were (12.60±1.13) points, (12.53±0.99) points, and (12.58±1.24) points, respectively, significantly higher than the corresponding scores in the control group ((9.25±1.13) points, (9.18±1.34) points, (10.35±0.86) points, respectively). These differences were statistically significant (t=13.291, 12.747, 9.322; P<0.05). The rapid recovery compliance rate was 97.50% (39/40) in the study group, which was higher than 80.00% (32/40) in the control group, and the difference was statistically significant (χ²=6.135, P=0.013). The time to first ambulation, duration of chest drainage tube placement, total hospital stay, and postoperative pain score in the study group were (6.13±1.32) hours, (22.60±1.50) hours, (12.48±1.54) days, and (2.83±1.13) points, respectively. These values were lower than those in the control group ((11.25±1.19) hours, (27.38±2.07) hours, (18.35±2.09) days, (4.33±1.12) points, respectively), and the differences were statistically significant (t=-18.187, -11.811, -14.306, -5.968, P<0.05). The postoperative pulmonary complication rate was 5.00% (2/40) in the study group and 22.50% (9/40) in the control group, with no statistically significant difference (χ²=3.794, P>0.05). Conclusion: Combining positive assimilation nursing with MDT-ERAS chain nursing in patients undergoing lung cancer surgery improves patients’ hope level and rapid recovery compliance, which helps achieve the goal of safe and rapid recovery.

Key words: Carcinoma, non-small-cell lung, Rehabilitation nursing, Comparative study

中图分类号:

R563.1+2

郑丽晶. 正性同化护理联合多学科-快速康复链式管理在肺癌胸腔镜手术患者中的应用[J]. 结核与肺部疾病杂志, 2026, 7(3): 333-337. doi: 10.19983/j.issn.2096-8493.20250139

Zheng Lijing. The application of positive assimilation nursing combined with MDT-ERAS chain nursing in patients undergoing lung cancer surgery[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(3): 333-337. doi: 10.19983/j.issn.2096-8493.20250139

图/表 4

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组别	积极行动态度		现实未来态度		亲密关系
组别	护理前	护理后	护理前	护理后	护理前	护理后
观察组(40例)	7.13±0.91	12.60±1.13^a	7.18±0.87	12.53±0.99^a	7.30±0.99	12.58±1.24^a
对照组(40例)	7.10±0.84	9.25±1.13^a	7.50±0.91	9.18±1.34^a	7.33±0.92	10.35±0.86^a
t值	0.128	13.291	-1.633	12.747	-0.117	9.322
P值	0.899	<0.05	0.106	<0.05	0.907	<0.05

组别	例数	肺部感染	肺不张	气胸	合计[例(发生率,%)]
观察组	40	1	0	1	2(5.00)
对照组	40	4	2	3	9(22.50)
χ²值					3.794
P值					0.051

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