快速康复外科在老年开腹大肠癌手术中的应用研究  

Role of fast track surgery in elderly patients after open resection for colorectal cancer

作　　者：曹益晟[1] 余永明[1] 戴晓宇[1] 宋宝荣[1] 韩俊毅[2] 陈蓓蕾[1] 

机构地区：[1]宁波市第二医院,浙江宁波315000 [2]同济大学附属东方医院

出　　处：《腹部外科》2015年第4期227-230,共4页Journal of Abdominal Surgery

基　　金：宁波市临床特色重点专科项目（2013-88）;上海浦东新区学科带头人培养计划（PEWd2010-05）

摘　　要：目的：研究快速康复外科（fast track surgery,FTS）对接受开腹手术的老年大肠癌病人中术后恢复的影响及其临床意义。方法将108例接受开腹大肠癌根治术老年病人（〉65岁）随机分成两组,即快速康复（fast track,FT）组（50例）和传统治疗组即对照组（58例）。分别统计两组病人的术后肛门排气时间、术后住院时间、住院费用及并发症发生率。结果两组共104例完成实验,其中 FT 组46例,对照组58例,两组在术后肛门排气时间、术后住院时间、住院费用方面 FT 组均少于对照组（P〈0.05）,在并发症发生率方面,两组吻合口瘘、切口愈合不良、肠梗阻、尿潴留发生率比较差异无统计学意义,而肺部感染、尿路感染的发生率 FT 组少于对照组（P〈0.05）。结论快速康复外科对促进大肠癌病人术后恢复,特别是对于开腹手术的老年病人,较传统治疗手段具有一定优势,可在相应人群中推广。Objective To explore the efficacy and clinical significance of fast track surgery （FTS）in elderly patients after open resection for colorectal cancer.Methods A total of 108 elderly patients undergoing laparotomy for colorectal cancer were randomly divided into two groups of FT and conventional treatment （control）.And the parameters of postoperative anal exhaust time,length of postoperative stay,hospitalization expense and incidence of complications were compared for both groups.Results And 46 subjects in FT group and 58 in control group completed the study.FT group offered better outcomes in postoperative anal exhaust time,length of stay and hospitalization expense than control group （P〈0.05）.The occurrences of anastomotic leakage,delayed wound healing,intestinal obstruction and uroschesis had no significant inter-group differences.And the incidence rates of pulmonary and urinary tract infections decreased in FT group （P〈0.05）.Conclusions Compared with conventional treatment,laparotomic FTS offers multiple advantages for elderly colorectal cancer patients during postoperative recovery.And wider popularization is desired.

关 键 词：老年 大肠癌 快速康复外科 开腹手术 

分 类 号：R619[医药卫生—外科学]