加速康复外科在结肠癌手术中的应用效果评价  

Evaluation of the effect of enhanced recovery after surgery protocol in colon cancer surgery

作　　者：陈声飞[1] 胡斌[1] 邓剑[1] 胡绚芳 邓守庭[1] 倪新建[1] 阙剑锋 

机构地区：[1]广东博罗县人民医院普通外科,广东博罗516100

出　　处：《消化肿瘤杂志（电子版）》2017年第1期39-42,共4页Journal of Digestive Oncology(Electronic Version)

摘　　要：目的探讨加速康复外科理念在结肠癌手术中的应用价值。方法选取从2014年1月至2016年7月我院72例结肠癌手术患者作为研究对象,根据围术期处理措施的不同分为两组,采用加速康复外科措施的39例患者纳入加速康复外科组(ERAS组),采用常规处理方案的33例纳入常规组。观察两组患者首次肛门排气时间、首次排便时间、平均静脉输液时间、术后住院时间、住院费用、术后超敏C反应蛋白(hs-CRP)水平及术后并发症的情况。结果与常规组相比,ERAS组首次肛门排气时间[(28.52±5.53)h vs.(46.15±7.91)h,P=0.003]、首次排便时间[(50.63±10.34)h vs.(78.01±13.64)h,P=0.004]、平均静脉输液时间[(4.33±1.41)d vs.(6.73±1.81)d,P=0.017]、术后住院天数[(4.95±1.32)d vs.(9.56±2.32)d,P=0.006]均缩短;住院费用减少[(24276.5±2335.3)元vs.(29263.6±2552.4)元,P=0.001];术后并发症发生率降低(5.12%vs.30.31%,P=0.001);术后hs-CRP水平明显低于常规组(P<0.05)。结论加速康复外科在结肠癌根治术中应用是安全有效的并且加速患者恢复。Objective To explore the clinical efficiency of enhanced recovery after furgery （ERAS） in colon cancer surgery. Methods From January 2014 to July 2016, Seventy-two patients with colon cancer in our hospital were divided into two groups according to different perioperative management. 39 patients who had used ERAS protocol in perioperative period were in the ERAS group. Other 33 patients who had used traditional protocol were in the control group. We observed the first flatus time, the first defecation time, av- erage venous transfusion time, length of postoperative stay, hospitalization expenses, postoperative hypersensi- tive C-reactive protein （hs-CRP） level and postoperative complications. Results In ERAS group, the first flatus time [（28.52±5.53）h vs. （46.15±7.91）h,P=0.003], the first defecation time [（50.63 ±10.34）h vs. （78.01±13.64）h,P=0.004], average venous transfusion time [（4.33±1.41）d vs. （6.73±0.81）d,P=0.017], length of postoperative stay [（4.95±1.32）d vs. （9.56±2.32）d,P=0.006] were shorter than those in control group. The hospitalization expenses [（24276.5±2335.3）RMB vs. （29263.6±2552.4）RMB,P=0.001] and the incidence of postoperative complications [5.12% vs. 30.31% ,P=0.001] in the ERAS group were lower than those in control group. The levels of hs-CRP in the ERAS group were lower than that in the control group （P〈0.05）. Conclusions ERAS protocol is safe and effective in radical colon cancer surgery. It can promote the recov- ery of patients.

关 键 词：结肠癌 围术期 加速康复外科 

分 类 号：R735.35[医药卫生—肿瘤]