腹腔镜结直肠癌切除术后快速康复理念对患者胃肠功能恢复及并发症的影响  

Effect of rapid rehabilitation concept on recovery of gastrointestinal function and complications after laparoscopic colorectal resection

作　　者：刘刚[1] 沈晓军 孙克康 刘丰 

机构地区：[1]江苏大学附属昆山市第一人民医院胃肠外科,江苏苏州215300

出　　处：《中国临床研究》2018年第1期66-69,共4页Chinese Journal of Clinical Research

摘　　要：目的评价腹腔镜结直肠癌切除术后快速康复理念的应用对患者胃肠功能恢复及并发症的影响。方法将2013年5月至2017年5月收治的120例行腹腔镜结直肠癌切除术的结直肠癌患者纳入本研究,采用随机数字表法将其分为观察组(n=63)和对照两组(n=57)。对照组患者采用传统围术期处理,观察组患者以快速康复理念为基础进行围手术期临床处理及健康教育,比较两组患者炎症反应、胃肠功能恢复、住院床日及并发症的发生情况。结果观察组患者术后肛门首次排气时间[(22.95±5.36)h]、第1次排便时间[(13.23±3.69)h]、住院床日[(5.51±1.48)d],均短于对照组患者[(30.67±8.03)h、(18.87±4.11)h、(9.27±2.91)d],差异有统计学意义(P均<0.01)。术前两组患者C反应蛋白(CRP)、外周血白细胞(WBC)水平相近(P均>0.05);术后两组均呈先上升后下降,且术后第3天、第7天观察组患者CRP、WBC水平均低于对照组,差异有统计学意义(P均<0.01)。观察组并发症发生率(7.94%)低于对照组(24.56%,P<0.05)。结论对行腹腔镜结直肠癌切除术的结直肠癌患者采取以快速康复理念为基础的围手术期临床处理及健康教育,可有效改善炎症反应,加快术后肛门恢复排气及第1次排便时间,促进胃肠功能恢复,降低并发症发生率,加速患者术后恢复,减少住院床日。Objective To evaluate the effects of rapid rehabilitation concept on recovery of gastrointestinal fimction and complications after laparoscopic colorectal cancer resection. Methods A total of 120 patients with colorectal cancer undergoing laparoscopic resection from May 2013 to May 2017 were enrolled and divided into observation group （n = 63 ） and control group（ n = 57 ） by random number table method. The traditional perioperative treatment was performed in control group, and the perioperative treatment based on rapid rehabilitation concept with health education in observation group. The inflammatory reaction, recovery of gastrointestinal function, hospital bed-days and incidence of complications were compared between two groups. Results The first anal exhaust time [ 22. 95± 5.36 ） h ], the first defecation time [ （ 13.23 ±3.69 ） h ] and the hospital bed-days [ （5.51± 1.48 ） d] in observation group were statistically shorter than those[ （ 30. 67 ±8.03 ） h, （ 18.87 ± 4.11 ） h, （9. 27 ± 2. 91 ） d, respectively ] in control group （ all P 〈 0. 01 ）. The levels of C-reaction protein （CRP） and peripheral blood leukocyte were similar before operation （ all P 〉 0. 05 ） and first increased and then decreased after operation in both two groups. At 3th, 7th day after operation, the levels of CRP and WBC in observation group were significantly lower than those in control group（ all P 〈 0.01 ）. The complication rate in observation group was significantly lower than that in control group （7.94% vs 24. 56% ,P 〈 0. 05 ）. Conclusions The rapid rehabilitation concept based on perioperative clinical treatment and health education can effectively improve the inflammatory reaction, accelerate postoperative flatus and defecation time, promote the recovery of gastrointestinal function, reduce the incidence of complications,accelerate the postoperative recovery of patients and reduce the hospital bed-days of laparoscopic colorectal resection in patients with colorectal can

关 键 词：结直肠癌 腹腔镜结直肠癌切除术 快速康复理念 胃肠功能 炎性指标 

分 类 号：R735.3[医药卫生—肿瘤]