快速康复外科理念指导下的结直肠癌围手术期处理  

Perioperative management guided by the idea of fast track surgery in colorectal cancer

作　　者：龚龙波[1] 吕孝鹏[1] 孟良[1] 夏红[1] 谢志远[1] 

机构地区：[1]东南大学医学院附属徐州医院胃肠外科,徐州市221009

出　　处：《中华结直肠疾病电子杂志》2013年第5期224-227,共4页Chinese Journal of Colorectal Diseases(Electronic Edition)

摘　　要：目的观察快速康复外科理念指导下的结直肠癌围手术期处理对患者临床结果的影响。方法将2011年9月至2012年10月间东南大学医学院附属徐州医院胃肠外科收治的需手术治疗的结直肠癌患者100例随机分为快速康复组及传统治疗组,每组50例,分别采用快速康复外科和传统方法进行围手术期处理,比较2组患者术后恢复情况、营养状况及并发症发生率。结果 93例完成实验,其中快速康复组43例,传统治疗组50例,快速康复组与传统治疗组术后首次排气时间[(55.5±16.7)h比(69.3±20.1)h,P<0.01]、排便时间[(66.1±10.4)h比(79.1±16.4)h,P<0.01]、住院时间[(7.7±2.1)d比(9.6±2.7)d,P<0.05]均有差异,且差异统计学意义;术后第5天快速康复组白蛋白及前白蛋白水平均高于传统治疗组,差异有统计学意义;快速康复组患者术后疼痛感受明显减轻;两组患者吻合口瘘、肺部感染、尿路感染、切口感染及腹泻等并发症的发生率无显著差异。结论快速康复外科理念指导下的结直肠癌围手术期处理安全有效,能有效减轻患者疼痛感受,促进肠道功能恢复,改善患者营养状况以及缩短住院时间。To investigate the clinical outcomes of perioperative management guided by the idea of fast track surgery in colorectal cancer.Methods A controlled randomized clinical trial was conducted from September 2011 to October 2012 in the department of Gastrointestinal Surgery, Xuzhou Hospital,Medical College of Southeast University.A total of 100 patients with colorectal cancer who would undergo elective operation were randomly divided into two groups:a fast-track group ( 50 cases ) and a conventional treatment group ( 50 cases ) .Clinical parameters, markers of nutrition and postoperative complications were recorded and evaluated in both groups postoperatively.Results Ninety three patients eventually completed the study,43 cases in fast-track group and 50 cases in conventional treatment group.As compared to the conventional treatment group, the first postoperative time of flatus of fast-track group was significantly shorter in the fast-track group[(55.5 ±16.7)h vs.(69.3 ±20.1)h,P<0.01],as were the first passage of stool[(66.1 ±10.4)h vs.(79.1 ±16.4)h,P<0.01]and the length of stay[(7.7 ±2.1)d vs.(9.6 ±2.7)d,P<0.05].The levels of albumin and prealbumin were significant higher in the fast-track group as compared to the conventional treatment group on postoperative day 5.The patients of fast-track group felt less pain after operations.The differences of anastomotic leakage, pulmonary infection, urinary tract infection,wound infection and diarrhea were not statistically significant between the two groups(P>0.05). Conclusions Perioperative management guided by the idea of fast track surgery in colorectal cancer was safe and effective, can effectively reduce the pain, promote the intestinal function recovery, improve the nutritional status and reduce the time in hospital.

关 键 词：结直肠肿瘤 围手术期护理 快速康复外科 

分 类 号：R473.73[医药卫生—护理学]