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作 者:周大胜[1] 徐谔文[1] 陈建华[1] 祁洁[1]
机构地区:[1]南京医科大学附属苏州医院普通外科,江苏苏州215001
出 处:《现代肿瘤医学》2016年第10期1578-1581,共4页Journal of Modern Oncology
基 金:苏州市科技发展计划项目资助(编号:SYSD2012108)
摘 要:目的:比较加速康复外科治疗方案与常规治疗方法对胃肠道恶性肿瘤患者围手术期临床结果的影响。方法:60例胃肠道恶性肿瘤患者,随机分成加速康复外科(FTS)组30例与常规治疗方法(对照)组30例。比较两组患者术后住院时间、下床活动时间、肛门排气时间、进食半流质时间、住院费用及并发症的发生率等临床指标;并观察两组患者血浆白蛋白(ALB)、C-反应蛋白(CRP)、血糖、乳酸等实验室指标的变化;测定两组患者总淋巴细胞计数(TLC),T淋巴细胞亚群CD3、CD4、CD8、CD4/CD8比值的改变。结果:FTS组比对照组术后住院时间明显缩短,下床活动时间、肛门排气时间与进食半流质时间明显提前,住院费用也明显减少(P<0.01)。FTS组比对照组ALB下降幅度明显缩小(P<0.01),CRP、血糖、乳酸升高幅度明显缩小(P<0.01)。总淋巴细胞计数(TLC)、CD3、CD4、CD4/CD8比值等升高幅度FTS组比对照组均明显增加(P<0.05)。FTS组术后并发症总发生率与对照组比较无差异(P>0.05)。结论:加速康复外科能明显改善胃肠道恶性肿瘤手术患者的临床结果。Objective:To compare the clinical outcomes in gastroenterological malignant tumor patients with fast tract surgeU (FTS) and conventional treatment. Methods:All 60 cases of gastroenterological malignant tumor patients were randomly divided into fast tract surgeu(FTS) group (30 cases) and conventional treatment (control) group(30 cases) , to obsmwe time of hospital stay after operation, postoperative activity time and anal exhaust time and eating semiliquid time, hospitalization expense, the incidence of complications were compared between the two groups. We also obsmwed the variation ranges of albumin (ALB), creactive protein (CRP) ,glucose,lactic acid,total lymphocyte count( TLC), CD3 , CD4 , CDs , CD4/CD8. Results : In the FTS group, the hospitalization time was significantly shorter, the postoperative activity time and anal exhaust time and eating semiliquid time were significantly earlier, the hospital- ization expense was significantly decreased, the ALB fall rang and CRP rise rang and glucose rise rang and lactic acid rise rang were significantly reduced than those in the control group(P 〈 0.01 ). The total lymphocyte count(TLC) rise rang, CD3 rise rang, CD4 rise rang, CD4/CD8 rise rang were significantly increased in the FTS group than those in the control group ( P 〈 0.05 ). There was no difference in the total complication rate between the two groups ( P 〉 0.05 ). Conclusion:Fast track surgeU can significantly improve the clinical outcomes of gastroenterological malignant tumor patients.
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