加强术后康复概念在腹腔镜胃癌根治术中的应用评价  

Enhanced recovery after surgery in laparoscopic radical gastrectomy for gastric cancer

作　　者：刘作良[1] 谢雪虹 田洪鹏[1] 李利发 侯华芳[1] 张广军[1] 周彤[1] 梁小波[2] Liu Zuoliang;Xie Xuehong;Tian Hongpeng;Li Lifa;Hou Huafang;Zhang Guangjun;Zhou Tong;Liang Xiaobo(Department of Gastrointestinal Surgery,the Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院肝胆胰肠疾病研究所胃肠外科,南充637000 [2]山西省肿瘤医院消化内镜微创外科中心

出　　处：《中华普通外科杂志》2018年第12期1026-1029,共4页Chinese Journal of General Surgery

摘　　要：目的探讨加强术后康复的措施应用于腹腔镜胃癌根治术患者围手术期的有效性和安全性。方法选取2015年5月至2017年7月川北医学院附属医院胃肠外科收治的149例胃癌患者,随机分成实验组75例,给予加强术后康复措施;对照组74例,给予常规措施。结果实验组和对照组患者首次肛门排气时间分别为(51±11)、(62±11)h,首次进食时间分别为(46±12)、(68±20)h,胃管拔除时间分别为(13±12)、(70±16)h,术后第1天疼痛评分分别为(3.9±1.3)、(5.2±0.9),血清C反应蛋白分别为(8.5±2.6)、(10.1±3.0)mg/L,差异均有统计学意义(均P<0.05)。术后总的并发症发生率分别为25%、28%,差异无统计学意义(x^2=0.101,P=0.750)。术后住院时间分别为(6.9±2.9)d、(11.2±3.5)d,差异有统计学意义,P<0.05。结论加强术后康复措施应用于胃癌手术患者围手术期的管理能促进患者术后快速康复,缩短术后住院时间。Objective To evaluate the safety and effectiveness of dnhanced recovery after surgery (ERAS)in laparoscopie.radical gastrectomy for gastric cancer.Methods From May 2015 to July 2017, 149 patients with gastric cancer in our department were prospectively enrolled and randomly divided into the ERAS group (n=75)and control group (n=74).Results In ERAS group compared to control group, the time to first passage of flatus was (51±11)vs.(62±11)h,,first feeding time (46±12)vs.(68±20) h,gastric tube removal time (13±12)h vs.(70±16)h ,pain score on the first day after surgery (3.9±1.3)vs.(5.2±0.9),C-reaction protein level (8.5±2.6)mg/L vs.(10.1±3.0)mg/L,post-op hospital stay (6.9±2.9)d vs.(11.2±3.5)d,were all significantly different (all P <0.05).The postoperative complication rates was 25% vs.28%respectively,(x^2=0.101,P =0.750).Conclusions Enhanced recovery after surgery can promote the postoperative recovery and shorten the time of hospitalization in laparoscopic-assisted radical gastrectomy for gastric cancer.

关 键 词：胃肿瘤 围手术期 腹腔镜 加强术后康复 

分 类 号：R473.73[医药卫生—护理学]