Clinical application of multifunctional thoracic band in thoracic laparoscopy combined with esophageal cancer during perioperative period

doi:10.3877/cma.j.issn.1674-6902.2021.06.010

Abstract

Abstract:

Objective

To analyze the effect of multifunctional thoracic band on postoperative pulmonary complications in patients with thoracic laparoscopy combined with esophageal cancer during perioperative period.

Methods

A total of 62 patients who underwent thoracoscopic combined radical resection of esophageal cancer in our department from March 2019 to January 2021 were randomly divided into control group 34 cases and observation group 28 cases. The control group received traditional multi-horacic band after surgery, and the observation group received medical multi-unctional thoracic band developed by our hospital after surgery. Blood oxygen saturation, lung function indexes, time to get out of bed for the first time, total daily activity, exhaust and defecation, pulmonary complications were observed in 2 groups 1 d before surgery and 7 d after surgery.

Results

The preoperative pulmonary function indexes of observation group (P<0.05), maximal volume of pulmonary function (MVV), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁) on postoperative day 7 (P<0.01), and peripheral blood oxygen saturation after activity were higher than those in control group (P<0.05). The first time to get out of bed and the time to exhaust and defecate in the observation group were earlier than the control group (P<0.05), the total daily activity was significantly higher than the control group (P<0.01), and the postoperative pulmonary complications were lower than the control group (P<0.05).

Conclusions

Perioperative use of multifunctional thoracic band in patients undergoing thoracoscopy combined with esophagectomy can improve lung function, promote early ambulation, increase total activity, and reduce the incidence of pulmonary complications.

Key words: Thoracoscopic combination, Pulmonary complications, Minimally invasive resection of esophageal cancer, Medical multifunctional chest strap

Qian Wang, Zhenhua Wang, Jing Lu, Taigan Gong, Sha Tao, Lijiao Wang, Boshi Fan. Clinical application of multifunctional thoracic band in thoracic laparoscopy combined with esophageal cancer during perioperative period[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2021, 14(06): 753-756.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhfbjbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6902.2021.06.010

https://zhfbjbzz.cma-cmc.com.cn/EN/Y2021/V14/I06/753

Figures/Tables 3

References 30

1	Mariette C, Markar SR, Dabakuyo-Yonli TS, et al. Hybridminnimally invasiveesophagectomy for esophagealcancer[J]. N Engl J Med, 2019, 380(2): 152-162.
2	王　云，吴泽昊，黄宇光. 标准化与规范化：《食管切除术围手术期治疗指南：加速康复外科协会推荐》解读[J]. 协和医学杂志，2019, 10(6): 575-581.
3	龚太乾. 微创食管切除术术式演变与个体化选择[J]. 转化医学杂志，2019, 8(5): 262-265.
4	杨立民，张　震，凌　锋，等. 胸腹腔镜联合食管癌根治40例临床总结[J]. 中国内镜杂志，2016, 22(6): 94-96.
5	王文凭，何松林，杨玉赏，等. 食管癌微创外科的现状与思考[J]. 中国胸心血管外科临床杂志，2018, 25(4): 338-344.
6	叶永菁，张云魁，吉　勇，等. 集束化护理在胸腹腔镜联合食管癌切除术后病人胃肠功能障碍护理中的应用[J]. 护理研究，2018, 32(24): 3975-3978.
7	徐建锋，周军庆，魏德胜，等. 食管癌术后肺部并发症的预测与对策[J/CD]. 中华胸部外科电子杂志，2020, 7(04): 224-232.
8	蒋　然，魏　珂．食管切除术围手术期麻醉管理现状研究进展[J]. 医学综述，2019, 25(22): 4438-4443.
9	岳彩迎，宋伟安，刘军强，等. 空肠穿刺造瘘术在食管癌外科治疗中的应用：258例分析[J]. 转化医学杂志，2020, 9(6): 360-362.
10	郭宝钰. 开胸术后肺不张的原因及优质护理方法[J]. 继续医学教育，2017, 31(4): 121-122.
11	王丽君. 胸腔镜辅助下肺癌根治术与常规开胸手术对非小细胞肺癌的疗效与护理体会[J]. 中华肿瘤防治杂志，2018, 5(25): 212-213.
12	任　娜，吕　静. 食管癌围术期呼吸道管理的护理研究进展[J]. 中国老年医学杂志，2016, 36(7): 1769-1772.
13	程　春. 心胸外科老年患者围手术期的呼吸道管理[J]. 世界最新医学信息文摘，2016, 16(73): 279-280.
14	张　军，毕　波，彭传亮. 三切口食管癌切除术与胸腔镜辅助手术的疗效比较[J]. 腹腔镜外科杂志，2014, 19(4): 281-283.
15	施庆彤，刁亚丽，钱　军. 单孔胸腔镜手术联合ERAS理念指导下的呼吸功能锻炼在肺癌围手术期的应用[J]. 中国肺癌杂志，2020, 23(8): 667-672.
16	张义兵，洪志鹏. 食管癌术后肺部并发症的危险因素分析[J/CD]. 中华肺部疾病杂志(电子版), 2018, 11(5): 534-537.
17	赵海红，王瑞云，卓成玉，等. 呼吸训练器对老年食管癌切除患者术后肺功能及肺部并发症影响分析[J/CD]. 中国医学前言杂志(电子版), 2017, 9(9): 109-113.
18	金慧玉，王振华，朱　荔，等. 加速康复外科理念在胸腔镜肺叶切除患者中的临床应用观察[J]. 中华肺部疾病杂志(电子版), 2017, 10(3): 349-351.
19	李舒玲，蒋　璇，王　蓓. 自制可调气压外固定胸带在开胸术后的应用[J]. 护理学杂志，2015, 30(6): 24-25.
20	马少颜. 心胸外科开胸术后胸部固定的现状及进展[J]. 全科护理，2018, 16(33): 4136-4140.
21	郭　瑾，蒋恩社，刘东英. 快速康复外科在食管癌病人围术期护理中的应用研究进展[J]. 全科护理，2017, 15(33): 4127-4130.
22	冯　娟，朱春燕，陈　丽. 快速康复理念在食管癌围术期护理应用效果及抗炎作用的Meta分析[J]. 国际护理学杂志，2018, 37(4): 433-439.
23	陈梦云，黄琼珊，李　玲，等. 医护一体化结合快速康复外科在食管癌患者围手术期应用的效果观察[J]. 现代临床护理，2020, 19(3): 25-31.
24	栾颖，都盼盼，张广娟. 快速康复外科干预对老年食管癌患者术后康复效果、营养状况及预后的影响[J/CD]. 中国医学前言杂志(电子版), 2020, 12(11): 48-52.
25	方忠民，蓝　斌，杨彦龙，等. 快速康复外科理念在胸腔镜肺癌手术中的应用[J]. 广东医学，2015, 36(8): 1226-1228.
26	陶　莎，王振华，王丽娇，等. 快速康复外科护理对单孔胸腔镜肺叶切除术后患者肺功能的影响分析[J/CD]. 中华肺部疾病杂志(电子版), 2019, 12(2): 220-222.
27	王敏婕，赵春梅. 胸部手术后有效叩背排痰的研究进展[J]. 循证护理，2020, 6(8): 782-784.
28	张静文，谭晓骏，王振华，等. 充气式多功能胸带在微创食管癌根治术中的应用[J]. 医学临床研究，2018, 35(1): 143-145.
29	李舒玲，蒋　璇，王　蓓．自制可调气压外固定胸带在开胸术后的应用[J]. 护理学杂志，2015, 30(6): 24-26.
30	王振华，金慧玉，朱　荔，等. 充气式多功能胸带对胸部手术患者快速康复的影响[J]. 国际护理学杂志，2018, 37(1): 127-129.

组　别	例数	FEV₁(%)		FVC(%)		MVV(L)		SaO₂(%)
组　别	例数	O₁	O₂	O₁	O₂	O₁	O₂	O₁	O₂
观察组	34	69.76±0.74	66.48±0.86	71.80±1.66	73.11±1.12	82.69±1.39	80.96±4.06	98±1.1	96.82±1.15
对照组	28	65.93±0.87	61.08±1.10	64.79±2.07	64.91±1.08	75.57±2.55	73.62±5.58	97±1.9	91.73±0.83
t值		3.45	3.60	2.65	5.87	2.33	4.83	1.42	3.88
P值		0.01	0.01	0.03	0.00	0.04	0.00	0.06	0.00

组　别	例数	FEV₁(%)		FVC(%)		MVV(L)		SaO₂(%)
组　别	例数	O₁	O₂	O₁	O₂	O₁	O₂	O₁	O₂
观察组	34	69.76±0.74	66.48±0.86	71.80±1.66	73.11±1.12	82.69±1.39	80.96±4.06	98±1.1	96.82±1.15
对照组	28	65.93±0.87	61.08±1.10	64.79±2.07	64.91±1.08	75.57±2.55	73.62±5.58	97±1.9	91.73±0.83
t值		3.45	3.60	2.65	5.87	2.33	4.83	1.42	3.88
P值		0.01	0.01	0.03	0.00	0.04	0.00	0.06	0.00

组　别	例数	首次活动(h)	日活动总量(m)	排气时间(h)	排便时间(h)
观察组	34	16.20±0.84	987.69±233.53	69.80±1.96	74.47±0.84
对照组	28	20.33±0.67	732.29±70.89	62.11±1.68	79.17±1.61
t值		-3.04	5.81	2.96	-2.70
P值		0.01	0.00	0.01	0.02

组　别	例数	首次活动(h)	日活动总量(m)	排气时间(h)	排便时间(h)
观察组	34	16.20±0.84	987.69±233.53	69.80±1.96	74.47±0.84
对照组	28	20.33±0.67	732.29±70.89	62.11±1.68	79.17±1.61
t值		-3.04	5.81	2.96	-2.70
P值		0.01	0.00	0.01	0.02

[1]	Li-zhi LV, Xiao-jin ZHANG, Qiu-cheng CAI, Yi JIANG. Influence of retrograde reperfusion via vena cana on pulmonary complications after orthotopic liver transplantation [J]. Chinese Archives of General Surgery(Electronic Edition), 2011, 05(01): 3-6.
[2]	Jinze Li, Haibo Qiu, Chun Pan. Clinical application of high-flow nasal cannula in prevention of acute respiratory failure in extubated patients after surgery [J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2019, 05(03): 264-267.
[3]	Chinese Geriatrics Society Anesthesia Branch. Expert consensus on prevention and treatment of postoperative pulmonary complications in elderly patients [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(01): 7-22.
[4]	Jianfeng Xu, Junqing Zhou, Desheng Wei, Bing Wang, Linhai Fu, Zhupeng Li, Guangmao Yu. Prediction and prevention of postoperative pulmonary complications after esophageal cancer surgery [J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2020, 07(04): 224-232.
[5]	Canxing Wu, Shuqiao Hu, Jun Ma, Jiehuan Lin, Funan Chen. Predictors of pulmonary complications after lung cancer [J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2019, 06(04): 229-233.
[6]	Jie Du, Shaoming Zhang, Xiaoping Xu, Jie Chen, Lei WANG. Prevention and treatment of postoperative pulmonary complications after esophagectomy in elderly patients with esophageal carcinoma [J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2015, 02(04): 241-244.

Please choose a citation manager

Content to export