快速康复外科理念应用于胃癌患者围手术期的前瞻性随机对照研究  

Promotion of postoperative recovery with fast track surgery for gastric cancer patients ;undergoing gastrectomy：a prospective randomized controlled study

作　　者：王公平[1] 杨言通[1] 周博[1] 陈晔[1] 金灿辉[1] 汪增方 王珍珍[1] 张伟[1] 冯笑山[1] 

机构地区：[1]河南科技大学第一附属医院胃肠肿瘤外科,洛阳471003

出　　处：《中华胃肠外科杂志》2014年第5期489-491,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的：探讨快速康复外科（FTS）理念应用于胃癌患者围手术期管理对促进患者术后康复的安全性和有效性。方法前瞻性入组2013年1-11月间河南科技大学第一附属医院胃肠肿瘤外科收治的71例胃癌患者，按随机数字表法随机分为干预组和对照组，干预组按照FTS方案管理，对照组按照传统方式管理，比较两组术后恢复情况及应激程度。结果干预组较对照组术后通气时间提前[（67．8±19．7） h比（90．0±20．6） h， P＜0．01]、术后住院时间缩短[（13．5±3．0） d比（17．8±7．3） d， P＝0．01]、住院费用降低[（2．38±0．37）万元比（2．78±0．61）万元， P＜0．05]，且术后疼痛评分、白细胞及C反应蛋白等应激指标降低（均P＜0．01），肠梗阻、感染、吻合口瘘等术后并发症发生率并未增高（均P＞0．05）。结论 FTS应用于胃癌患者围手术期管理可减轻术后应激，促进患者术后康复。Objective To study the safety and feasibility of fast track surgery （FTS） in the promotion of postoperative recovery for gastric cancer patients undergoing gastrectomy. Methods From January to December in 2013, 71 gastric cancer patients were prospectively enrolled and randomized into the FTS group and the control group. Patient in the FTS group received FTS management and those in the control group received routine management. The postoperative recovery and stress were compared between the two groups. Results FTS was associated with shorter time to bowel function return[（67.8±19.7） h vs. （90.0±20.6） h, P〈0.01], shorter hospital stay [（13.5±3.0） d vs. （17.8±7.3） d, P=0.01], lower hospital cost [（23.8±3.7） thousand Yuan vs. （27.8±6.1） thousand Yuan, P〈0.05], and less stress response（lower pain score, WBC count, C-reactive protein, all P〈0.01）. The postoperative complications including ileus, infection, anastomotic leakage were similar （all P＆gt;0.05）. Conclusion Fast track surgery decreases postoperative stress response and promotes recovery.

关 键 词：胃肿瘤 快速康复外科 应激反应 术后并发症 

分 类 号：R735.2[医药卫生—肿瘤]