Analysis Of Clinical Factors Of Enhanced Recovery After Pulmonary Nodules Resection And Study On Clinical Effect Of ERAS Measures

ObjectiveTo analyze the effects of different intervention measures and clinical factors on rapid rehabilitation after pulmonary nodule resection with logistic univariate and multivariate analysis,multiple linear regression and other methods.MethodFrom January 2019 to December 2020,a total of 213 patients with pulmonary nodules were treated by Robot-assisted Thoracic surgery(RATS)or Video-Assisted Thoracic Surgery(VATS)and were confirmed by clear pathological data after surgery,including 108 males and 105 females.Collect patient data: clinical related data include:age,sex,weight,body surface area,preoperative serum albumin,resection range,nodule nature,basic disease history,smoking history,operation time,number of lymph node dissection.ERAS-related measures: adopting different ways of taking tubes after operation,whether to use intercostal nerve block during operation,and whether to give airway preparation before operation.The postoperative hospital stay and complications(air leakage,lung infection,pleural effusion,atelectasis,etc.)were counted.T-test,Chi-square test,Fisher precision test,multivariate logistic regression analysis and multivariate linear regression were used to analyze whether there were statistical differences in postoperative hospital stay and complications under different factors and measures.ResultA total of 213 cases of pulmonary nodule resection were analyzed.Univariate analysis showed that the patients with pulmonary nodule were male(P < 0.05),heavy(P < 0.05),large body surface area(P < 0.05),low serum albumin before operation(P <0.05),and the resection range was greater than or equal to one lung lobe(P < 0.05)Age(P < 0.05),resection range greater than or equal to one lung lobe(P < 0.05),large number of lymph node dissection(P < 0.05)and low preoperative serum albumin(P <0.05)are the risk factors of complications after pulmonary nodule resection.Multivariate logistic analysis showed that the patients with pulmonary nodules had large body weight(P < 0.05),small body surface area(P < 0.05),resection area greater than or equal to one lung lobe(P < 0.05),and malignant nodules(P < 0.05),which were independent risk factors for the postoperative hospital stay of patients with pulmonary nodules.Older age(P < 0.05)and resection range greater than or equal to one lung lobe(P < 0.05)are independent risk factors for complications after resection of pulmonary nodules.The results of multiple linear regression analysis showed that the resection range was greater than or equal to one lung lobe(P < 0.05),the weight was heavier(P <0.05),and the age was older(P < 0.05),which were independent risk factors for prolonged hospitalization after pulmonary nodule resection.At the same time,patients with airway preparation before operation(P < 0.05),intercostal nerve block during operation(P < 0.05)and negative pressure drainage ball(F22 drainage tube,P < 0.05)have lower postoperative complications.Patients with airway preparation before operation(P < 0.05)and intercostal nerve block during operation(P < 0.05)had shorter postoperative hospital stay.Conclusion1.Large weight,small body surface area,resection area greater than or equal to one lung lobe,malignant nodule and other factors are independent risk factors for postoperative hospital stay of patients with pulmonary nodules > 7 days.2.Older age,resection range greater than or equal to one lung lobe are independent risk factors for postoperative complications of pulmonary nodules patients receiving ERAS.3.Pre-operative airway preparation,intraoperative intercostal nerve block and reducing the number of drainage tubes can shorten the postoperative hospital stay of patients with pulmonary nodules.4.Reducing the diameter of drainage tube can reduce postoperative complications.