加速康复外科技术对肝肿瘤患者术后恢复的影响  

Effects of fast-track surgery on postoperative rehabilitation of patients with liver cancer

作　　者：胡捷[1] 李宗军[2] 樊嘉[1] 徐泱[1] 周俭[1] 沈英皓[1] 肖永胜[1] 王征[1] 

机构地区：[1]复旦大学附属中山医院肝外科复旦大学肝癌研究所,上海200032 [2]重庆市急救医疗中心,400014

出　　处：《中华消化外科杂志》2009年第4期281-283,共3页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金（30873039）;上海市科委国际科技合作基金（07SP07003）

摘　　要：目的探讨加速康复外科技术对肝肿瘤切除患者术后早期恢复的影响。方法选取2008年7月9日至7月30日复旦大学附属中山医院收治的41例肝肿瘤切除患者，按随机数字表法分为加速康复外科技术干预组（20例）和常规处理对照组（21例），干预组采用加速康复外科技术方案，对照组采用传统围手术期治疗方案，采用t检验和，检验等比较两组患者术后下床时间、肛门排气及排便时间、术后并发症、住院时间及费用和术后第1、3、5天营养及代谢指标、肝肾功能、免疫及应激等指标。结果干预组术后下床时间、肛门排气及排便时间、出院时体质量、住院费用、术后第1、3、5天TBil、术后第3天TNF-α平与对照组比较差异有统计学意义（t=7．065，5．483，3．754，2．291，2．289，3．218，3．192，2．434，2．089，P〈0．05）。结论加速康复外科技术能加快肝肿瘤切除患者的术后恢复。Objective To investigate the effects of fast-track surgery on postoperative rehabilitation of patients with liver cancer. Methods Forty-one patients with liver cancer who had been admitted to Zhongshan Hospital of Fudan University from 9 to 30 in July 2008 were randomly divided into fast-track surgery group （ n = 20） and routine treatment group （n = 21 ） according to the random number table. Patients in fast-track surgery group were preoperatively educated in order to lessen their anxiety. Bowel preparation was not applied before operation, and they were orally administered with 1000 ml of enteral nutrition emulsion （1300 kcal）, then they were fasted for 4 hours before operation. Urethral catheter and gastric tube were removed after operation. They were orally administered with 1000 ml of enteral nutrition emulsion on postoperative day 2, and were encouraged to partake in off-bed activity shortly after the operation. The off-bed time, anus exhaust time, postoperative complications, hospitalization time, expense, nutritional and metabolic indexes on postoperative day 1, 3 and 5, hepatic and renal function, immune and stress indexes between the 2 groups were compared by t test and chi-square test. Results There were significant differences in off-bed time, anus exhaust time, patients＇ weight, expense, total bilirubin level on postoperative day 1, 3 and 5, and level of serum TNF-α on postoperative day 3 between the 2 groups （t = 7. 065, 5. 483, 3. 754, 2. 291, 2. 289, 3. 218, 3. 192, 2. 434, 2. 089, P 〈 0.05）. Conclusions Fast-track surgery can accelerate the postoperative rehabilitation of patients with liver cancer.

关 键 词：肝肿瘤 加速康复外科 

分 类 号：R735.7[医药卫生—肿瘤]