快速康复外科理念应用于老年进展期胃癌患者围术期的回顾性对照研究  

Retrospective Study of Fast-track Surgery Applied in the Perioperativeperiod of Elderly with Advanced Gastric Carcinoma

作　　者：裴哲[1] 周博[1] 金灿辉[1] 汪增方 杨言通[1] 智鹏柯[1] 郭东蛟 张伟[1] 王珍珍[1] 孟元普[1] 陈晔[1] 解延飞[1] 王公平[1] Pei Zhe Zhou Bo Jin Canhui et al(The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Henan 471003, China)

机构地区：[1]河南科技大学临床医学院、河南科技大学第一附属医院,洛阳471003

出　　处：《医学研究杂志》2017年第7期129-133,共5页Journal of Medical Research

摘　　要：目的探讨快速康复外科(fast-track surgery,FTS)理念在老年人进展期胃癌患者术后康复的安全性和有效性。方法回顾性纳入2013年1月~2016年6月间河南科技大学第一附属医院胃肠肿瘤外科收治的122例老年(年龄≥60岁)进展期胃癌患者,其中围术期按照快速康复外科理念管理65例,按照传统管理57例。比较两组手术情况、术后恢复情况及应激程度。结果 FTS组较对照组术中麻醉时间、输液量均减少、术后通气时间提前、术后住院时间缩短、住院费用降低(P<0.05)且白细胞计数和C反应蛋白等应激指标均降低(P<0.05),两组的手术时间、术中出血量、清扫的淋巴结数和肠梗阻、感染、吻合口瘘等术后并发症率差异无统计学意义(P>0.05)。结论 FTS用于老年进展期胃癌患者围术期管理方法安全可行,值得临床推广。Objective To explore the safety and efficacy of fast - track surgery （FTS） in postoperative rehabilitation of elderly pa- tients with advanced gastric carcinoma. Methods We reviewed 122 elder patients （older than 60 years） with advanced gastric carcinoma in the gastrointestinal tumor surgery of the First Affiliated Hospital of Henan University of Science and Technology from January, 2013 to June,2016. In perioperative period, there were 65 cases in accordance with the FTS management, 57 cases of the traditional management. The operation situation, postoperative recovery and stress degree of both groups were compared. Results Compared with control group, the intraoperative anesthesia time of FTS group was shorter, the transfusion volume was decreased, posterior ventilation time was ad- vanced, postoperative hospital stays were shortened, hospitalization expense was reduced （P 〈 0.05） , the stress markers including WBC and CRP were decreased （P 〈 0.05 ）. There was no statistical significance in the operation time, intraoperative blood loss and number of dissected lymph nodes and the rate of postoperative complications including intestinal obstruction, infection and anastomotic fistula （ P 〉 0.05 ）. Conclusion The application of FTS in the perioperatlve management of elderly patients with advanced gastric carcinoma is safe and feasible, which is worthy of clinical promotion.

关 键 词：快速康复外科 老年人 胃癌 预后 

分 类 号：R735.2[医药卫生—肿瘤]