快速康复外科对右半结肠癌根治术的作用  

CLINICAL VALUE OF FAST TRACK SURGERY USED IN RIGHT COLON CANCER RADICAL

作　　者：敖平[1] 林旭辉[1] 

机构地区：[1]惠州市第三人民医院,广东惠州516000

出　　处：《现代医院》2015年第8期50-52,56,共4页Modern Hospitals

摘　　要：目的：探讨快速康复外科（ fast track surgery，FTS）在右半结肠癌根治术的临床实施策略及效果。方法随机选取2013年6月∽2014年12月期间拟行腹腔镜根治术治疗的右半结肠癌根患者72例并按数字随机法分为观察组和对照组各36例。观察组根据FTS进行治疗策略的制定和实施，对照组采取传统腹腔镜根治术治疗。统计两组应激反应、手术时间、术中出血量、首次排气时间、首次排便时间、停止输液时间、术后引流量、拔除引流管时间、术后住院时间及术后并发症发生情况。结果两组术前血皮质醇、空腹血糖、血清IL－6和血浆CRP水平、手术时间和术中出血量比较差异均无统计学意义（p＞0.05）。两组术后24 h血皮质醇、空腹血糖、血清IL－6和血浆CRP水平均较术前出现不同程度的升高，且观察组24 h血皮质醇、空腹血糖、血清IL－6和血浆CRP水平均较对照组降低，差异有统计学意义（ p＜0.05）。观察组术后首次排气时间、首次排便时间、停止输液时间、拔除引流管时间和术后住院时间分别为（43．62±8．21）h、（50．42±6．85）h、（5．51±1.08）d、（4．12±0．85）和（5．42±1．13）d，均短于对照组的（56．65±8．26）h、（64．78±8．26）h、（9．53±4．13）d、（7．78± 1.43）d 和（10．62±2．14）d，差异有统计学意义（p ＜0.05）。观察组术后引流量[（602．54±165．78）ml]少于对照组[（1265.28±572．94）ml]，并发症的总发生率（8．33％）亦低于对照组（25．00％），差异有统计学意义（p＜0.05）。结论根据FTS进行腹腔镜右半结肠癌根治术治疗策略的制定和实施可有效促进患者康复并减少并发症的发生，值得临床推广使用。Objective To study the clinical implementation strategy analysis about fast track surgery （ FTS） used in right co-lon cancer radical.Methods 72 patients with right colon cancer laparoscopic treatment in our hospital from June , 2013 to Decem-ber, 2014 were randomly selected and divided into observation group （ n=36 ） and control group （ n =36 ） by numeric randomized method.Observation group adopted treatments based on FTS while control group treated with conventional laparoscopic radical prosta-tectomy.Stress reaction, operation time, intraoperative blood loss, exhaust time, defecation time, stop the infusion time, drainage a-mount and postoperative drainage tube root out time, postoperative hospital stay and postoperative complications of two groups were sta-tistically analyzed.Results Preoperative blood cortisol, fasting blood glucose, serum IL-6 and plasma CRP level of two groups, op-eration time and compare differences of 2 groups had no statistical significance （p〉0.05）.Postoperative 24 h blood cortisol, fasting blood glucose, serum IL-6 and plasma CRP level of two groups were higher than that of preoperative.Postoperative 24 h blood corti-sol, fasting blood glucose, serum IL-6 and plasma CRP level of observation group were lower than that of the control group, and the difference was statistically significant （p〈0.05）.In observation group, the exhaust time, defecation time, drainage tube root out time, stop infusion time and postoperative hospital stay of observation group were （43.62 ±8.21） h, （50.42 ±6.85） h, （5.51 ± 1.08）, （4.12 ±0.85）d and （5.42 ±1.13）d respectively, which were shorter than the （56.65 ±8.26）h , （64.78 ±8.26） h, （9.53 ±4.13）d, （7.78 ±1.43） d and （10.62 ±2.14）d of the control group, and the difference was statistically significant （p 〈0.05）.Rainage amount of observation group[（602.54 ±165.78） ml] was less than that of the control group[（1265.28 ±572.94） ml];And the total complications incidence of obs

关 键 词：快速康复外科 右半结肠癌 根治术 临床 实施策略 

分 类 号：R735.35[医药卫生—肿瘤]