针刺联合加速康复外科护理对肺癌患者胸腔镜术后肺部并发症、排痰效果及术后住院时长的影响分析

doi:10.19983/j.issn.2096-8493.20260183

摘要/Abstract

摘要：

目的: 探讨针刺联合加速康复外科(enhanced recovery after surgery,ERAS)护理应用于肺癌胸腔镜手术治疗患者护理中的临床价值。方法: 采用前瞻性研究,选取2024年12月至2025年12月于甘肃省中医院收治的60例肺癌胸腔镜手术患者,采用分层区组随机化法分为观察组、对照组,每组各30例。对照组实施单纯ERAS护理,观察组在对照组基础上联合针刺干预(主穴:肺俞、膻中、天突、尺泽;配穴:足三里、丰隆、内关,术前 3d 至术后 7d,1次/d)。对比两组患者术后肺部并发症发生率,术后24h、48h、72h排痰量与排痰难度评分,术后首次下床时间、胸腔闭式引流管拔除时间及术后住院时长。结果: 观察组术后肺部并发症总发生率为6.7%(2/30),明显低于对照组的26.7%(8/30),差异有统计学意义(χ²=4.320,P=0.037)。术后24h、48h、72h,观察组排痰量[分别为(25.73±3.49)ml、(36.81±4.52)ml、(45.28±5.36)ml]均明显高于对照组[分别为(18.42±3.16)ml、(27.65±4.23)ml、(34.16±5.07)ml],差异均有统计学意义(t值分别为8.504、8.104、8.255,P值均<0.001);观察组排痰难度评分[分别为(4.12±0.85)分、(2.94±0.73)分、(1.65±0.54)分]均明显低于对照组[分别为(7.26±1.14)分、(5.83±0.96)分、(3.71±0.82)分],差异均有统计学意义(t值分别为12.095、13.125、11.492,P值均<0.001)。观察组术后首次下床时间、胸腔引流管拔除时间、术后住院时长[分别为(20.43±3.18)h、(3.24±0.51)d、(6.42±0.86)d]均明显短于对照组[分别为(32.16±4.25)h、(4.87±0.62)d、(9.74±1.13)d],差异均有统计学意义(t值分别为12.104、11.121、12.805,P值均<0.001)。结论: 针刺联合 ERAS 护理可有效改善肺癌胸腔镜术后患者排痰能力,降低术后肺部并发症风险,加快术后康复,缩短住院时间,值得临床推广应用。

关键词: 针刺, 肺肿瘤, 围手术期护理, 手术后并发症, 加速康复外科

Abstract:

Objective: To explore the clinical value of acupuncture combined with enhanced recovery after surgery (ERAS) nursing in the care of patients undergoing thoracoscopic surgery for lung cancer. Methods: A prospective study was conducted. A total of 60 patients with lung cancer receiving thoracoscopic surgery admitted to Gansu Provincial Hospital of Traditional Chinese Medicine from December 2024 to December 2025 were enrolled and divided into observation group and control group by stratified block randomization, with 30 cases in each group. The control group received ERAS nursing alone, while the observation group received additional acupuncture intervention based on the regimen of the control group (main acupoints: Feishu (BL13), Tanzhong (CV17), Tiantu (CV22), Chize (LU5); auxiliary acupoints: Zusanli (ST36), Fenglong (ST40), Neiguan (PC6); once daily from 3 days before surgery to 7 days after surgery). The incidence of postoperative pulmonary complications, sputum volume and expectoration difficulty score at 24 h, 48 h and 72 h after surgery, time to first ambulation after surgery, removal time of closed thoracic drainage tube and postoperative hospital stay were compared between the two groups. Results: The total incidence of postoperative pulmonary complications in the observation group was 6.7% (2/30), which was significantly lower than 26.7% (8/30) in the control group, and the difference was statistically significant (χ²=4.320, P=0.037). At 24 h, 48 h and 72 h after surgery, the sputum volume in the observation group ((25.73±3.49) ml, (36.81±4.52) ml, (45.28±5.36) ml, respectively) was significantly higher than that in the control group ((18.42±3.16) ml, (27.65±4.23) ml, (34.16±5.07) ml, respectively), with statistically significant differences (t=8.504, 8.104, 8.255, all P<0.001). The expectoration difficulty scores of the observation group (4.12±0.85, 2.94±0.73, 1.65±0.54, respectively) were significantly lower than those of the control group (7.26±1.14, 5.83±0.96, 3.71±0.82, respectively), and the differences were statistically significant (t=12.095, 13.125, 11.492, all P<0.001). The time to first ambulation, removal time of thoracic drainage tube and postoperative hospital stay in the observation group ((20.43±3.18) h, (3.24±0.51) d, (6.42±0.86) d, respectively) were significantly shorter than those in the control group ((32.16±4.25) h, (4.87±0.62) d, (9.74±1.13) d, respectively), with statistically significant differences (t=12.104, 11.121, 12.805, all P<0.001). Conclusion: Acupuncture combined with ERAS nursing can effectively improve sputum expectoration capacity, reduce the risk of postoperative pulmonary complications, accelerate postoperative rehabilitation and shorten hospital stay in patients after thoracoscopic lung cancer surgery, which is worthy of clinical promotion and application.

Key words: Acupuncture, Lung neoplasms, Perioperative nursing, Postoperative complications, Enhanced recovery after surgery

中图分类号:

R245
R734.2

李玉萍, 马玉婷. 针刺联合加速康复外科护理对肺癌患者胸腔镜术后肺部并发症、排痰效果及术后住院时长的影响分析[J]. 结核与肺部疾病杂志,2026, 7(5): 648-652. doi: 10.19983/j.issn.2096-8493.20260183

Li Yuping, Ma Yuting. Analysis of the effect of acupuncture combined with enhanced recovery after surgery nursing on postoperative pulmonary complications, sputum expectoration and postoperative hospital stay in lung cancer patients undergoing thoracoscopic surgery[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(5): 648-652. doi: 10.19983/j.issn.2096-8493.20260183

图/表 3

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表3

参考文献 9

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组别	例数	肺不张	肺部感染	胸腔积液	低氧血症	合计
观察组	30	1(3.3)	0(0.0)	0(0.0)	1(3.3)	2(6.7)
对照组	30	3(10.0)	2(6.7)	1(3.3)	2(6.7)	8(26.7)
χ²值						4.320
P值						0.037

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