快速流程下限制补液策略对直肠癌术后早期康复的临床价值  

The clinical value of restrict rehydration strategy on early postoperative rehabilitation after rectal surgery in Fast - Track

作　　者：肖凌[1] 李维 李蔚[1] 汪晓东[3] 李立[3] 

机构地区：[1]四川大学华西口腔医学院,成都610041 [2]四川大学华西临床医学院 [3]四川大学华西医院胃肠外科中心

出　　处：《临床外科杂志》2010年第5期326-328,共3页Journal of Clinical Surgery

基　　金：基金项目：四川省卫生厅科学研究项目（编号：090353）

摘　　要：目的探索在快速流程模式下限制补液策略对直肠癌患者术后早期康复的影响。方法回顾性分析2007年12月至2008年5月四川大学华西医院肛肠外科收治的直肠癌患者资料，比较不同补液方案（限制补液组和常规补液组）对患者术后早期康复的影响。结果限制补液组术后首次进食、首次活动以及术后住院时间明显小于常规补液组，差异有统计学意义（P〈0．05）；限制补液组术后吻合口漏和肠梗阻的发生率明显小于常规补液组，差异有统计学意义（P〈0．05）。术后生化检查中，限制补液组和常规补液组的葡萄糖[（5．55±1．73）mmol／L与（6．82±2．74）mmol／L]的差异有统计学意义（P〈0．05）。结论术后限制补液策略可以缩短直肠癌患者术后首次进食、首次活动及术后住院时间，也可以减少患者术后吻合口漏和肠梗阻的发生率，对患者术后早期康复具有一定的促进作用。Objective To explore the impact of restrictive fluid administration on the early rehabilitation after rectal surgery under multi - disciplinary team. Methods From December 2007 to May 2008, the patients diagnosed definitely as colorectal cancer were analyzed retrospectively, the clinical effects on post - operative early rehabilitation were studied and the differences between restrictive fluid regimen and standard fluid regimen were compared. Results The time of post - operative first eating, first activity and hospitation of restrictive fluid group was shorter than those of standard fluid group, the difference had statistical significance （P 〈 0.05 ）. And the incidence of stomas fistula and intestinal obstruction of restrictive fluid group was lower than that of standard fluid group, the difference had statistical significance（P 〈0.05 ）. Comparing the biochemical indicators, the difference of post -operative GLU （5.55 ± 1.73 mmol/L vs 6.82± 2.74 mmol/L） were statistically significant （ P 〈 0.05 ）. Conclusion Restrictive fluid regimen can shorter the time of post - operative first eating, first activity and hospitation, and can reduce the incidence of stomas fistula and intestinal obstruction after rectal surgery, it has a certain promoter action to the early rehabilitation after rectal surgery.

关 键 词：液体治疗 康复 快速流程 直肠癌 限制液体 

分 类 号：R735.37[医药卫生—肿瘤]