快速康复外科理念在胃癌D2根治术围手术期的应用  

Application of rapid rehabilitation medicine in patients with gastric cancer D2 radical operation

作　　者：庞立阳[1] 马智慧[1] 马烨华[1] 廖翠君[1] 李泽亚[1] 

机构地区：[1]四川省阆中市人民医院外科,阆中637400

出　　处：《中国肿瘤临床与康复》2016年第8期988-991,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨胃癌D2根治术围手术期采用快速康复外科(FTS)理念的临床效果。方法选取2013年1月至2015年1月在四川省阆中市人民医院接受胃癌D2根治术治疗的146例患者,按照随机数字表法随机分为观察组和对照组,每组73例。观察组患者采用FTS理念护理,对照组患者用传统康复护理,比较两组患者治疗效果、手术情况、术后并发症。用Logistics回归分析胃癌D2根治术治疗效果的影响因素。结果观察组患者显效率和总有效率分别为46.6%、95.9%,显著高于对照组的28.8%和83.6%,差异均有统计学意义(P<0.05)。观察组患者手术时间、术中出血量、住院时间、术后出现吻合口瘘、感染以及腹胀腹泻等并发症均显著低于对照组,差异均有统计学意义(均P<0.05)。Logistic回归性分析显示,肿瘤大小、组织学分型、有无淋巴结转移、是否应用FTS以及TNM分期等5个影响因素与治疗效果相关。结论胃癌D2根治术围手术期应用FTS,可有效缩短手术时间和术后恢复时间,是否应用FTS是影响胃癌D2根治术的主要因素。FTS具有较高的应用价值,值得临床推广应用。Objective To explore the efficacy of fast track surgery（ FTS） in the perioperative period of gastric cancer D2 radical operation. Methods From January 2013 to January 2015 in Langzhong People＇s Hospital,146 gastric cancer patients with D2 radical resection were enrolled in the study and randomly divided into the observation group and the control group,73 cases in each group. The patients in the observation group accepted FTS and those in the control group accepted traditional rehabilitation. The treatment effect,operation,postoperative complications were compared between the two groups. Logistics regression analysis was used to analyze the therapeutic efficacy of D2 radical gastrectomy for gastric cancer.Results The explicit efficiency and total effective rate of the observation group was 46. 6%,95. 9%,were significantly higher than those in the control group of 28. 8% and 83. 6%. And the operation time,intraoperative blood loss,hospitalization time and postoperative complications such as anastomotic leakage,infection,abdominal distension and diarrhea in the observation group were significantly lower than those in the control group,with significant differences（ P〈0. 05）. Finally through Logistic regression analysis,the D2 radical therapy is effective as the dependent variable,the other factors as the independent variable,get 5 influencing factors： the tumor size,histological type,lymph node metastasis,whether FTS and TNM staging.Conclusions FTS in gastric D2 radical perioperation has significantly reduced the operative time and recovery time,and FTS is a major factor affecting the D2 radical gastrectomy for gastric cancer. It is worthy of clinical promotion.

关 键 词：胃肿瘤 围手术期 快速康复外科 并发症 护理 

分 类 号：R735.2[医药卫生—肿瘤]