加速康复外科理念在原发性肝癌肝切除术围手术期管理的应用价值  

Application value of enhanced recovery concept in perioperative management of hepatectomy for primary liver cancer

作　　者：彭浪[1] 王恺[1] 樊友文[1] 钟福平[1] 张翼[2] 邹书兵[1] 

机构地区：[1]南昌大学第二附属医院肝胆外科,江西南昌330006 [2]南昌大学第二附属医院胃肠外科,江西南昌330006

出　　处：《中国普通外科杂志》2017年第2期218-222,共5页China Journal of General Surgery

摘　　要：目的:探讨加速康复外科理念(ERAS)在原发性肝癌肝切除术围手术期应用的优越性。方法:将2015年7月—2016年6月收治的81例原发性肝癌肝切除术患者按照随机数字表法分成ERAS组(n=40)和对照组(n=41),ERAS组采用ERAS理念进行围手术期处理,对照组采用传统围手术期处理,比较两组患者的相关临床指标。结果:两组患者术前一般资料无明显差异(均P>0.05)。两组患者的手术方式、手术时间、术中出血量、术后并发症情况均无明显差异(均P>0.05),但ERAS组术后肛门排气排便时间、术后NRS评分、术后引流管拔除时间、术后住院时间均明显优于对照组(均P<0.05)。所有患者术后随访1~2个月,无出院30 d内再次住院或手术病例。结论:ERAS理念应用于肝癌肝切除术患者围手术期的管理安全有效,能加快患者术后恢复。Objective： To investigate the advantages of using enhanced recovery after surgery （ERAS） in perioperative management ofhepatectomy for primaryliver cancer. Methods： Eighty-one patients with primary liver cancer admitted from July 2015 to June 2016 were designate d to ERAS group （n=40） and control group （n=41） by using a random number table. Patients in ERAS group received perioperative management directed by ERAS concept, while those in control group underwent conventional perioperative management. The main clinical variables between the two groups of patients were compared. Results： The general perioperative data of the two groups of patients showed no significant difference （all P〉O.O5）. There were no significant differences in surgical types, operative time, postoperative complications between the two groups of patients, but the time to intraoperative blood loss and postoperative bowel function recovery, NRS scores, time to drainage tube removal, and length of postoperative hospital stay in ERAS group were all significantly superior to those in control group （all P〈0.05）. All patients were followed up for one month to two months, and there was no hospital readmission or reoperation in any of them within 30 d after surgery. Conclusion： Using ERAS concept in perioperative management of liver cancer resection is safe and effective, and it can accelerate the postoperative recovery of the patients.

关 键 词：癌 肝细胞 肝切除术 围手术期医护 

分 类 号：R735.7[医药卫生—肿瘤]