加速康复外科理念对低位直肠癌保肛术后病人的临床疗效、肛门动力学及生活质量的影响  

Influence of the concept of fast track surgery on clinical effect,anal dynamics and living quality in treatment of low retcal cancer anus saving patients

作　　者：李光华 孙健 王烁 LI Guanghua;SUN Jian;WANG Shuo(Department of General Surgery, the People＇s Hospital of Shenyang City, Liaoning Provincial, Shenyang 110016, China)

机构地区：[1]辽宁省沈阳市人民医院普外科,110016

出　　处：《临床外科杂志》2018年第5期346-348,共3页Journal of Clinical Surgery

摘　　要：目的探讨加速康复外科(FTS)理念对低位直肠癌保肛术后病人的临床疗效、肛门动力学及生活质量的影响。方法低位直肠癌病人(均行保肛手术)100例,将100例病人随机分为两组,研究组50例,采用FTS治疗理念,对照组50例,采用常规围术期处理方法,比较两组病人围术期相关指标及肛门功能等差异。结果两组病人手术时间比较差异无统计学意义(P>0.05)。研究组和对照组术中出血量分别为(221.4±93.1)ml和(263.2±76.4)ml,术后首次排气时间分别为(3.7±0.6)天和(5.6±0.8)天,术中输液量分别为(2261.5±670.2)ml和(2574.2±635.0)ml,术后住院时间分别为(8.5±2.1)天和(13.2±2.0)天,首次进食时间分别为(4.1±1.2)天和(6.6±1.8)天,两组比较差异有统计学意义(P<0.05);研究组病人术后总并发症发生率为18.0%,对照组为36.0%,两组比较差异有统计学意义(P<0.05);术后3个月,研究组病人肛门功能良好率为74.0%,对照组为54.0%,两组比较差异有统计学意义(P<0.05);研究组术后3个月的肛门最大收缩压及静息压、静息及收缩向量容积分别为(245.2±20.1)mmH g、(165.0±17.3)mmH g、(32792.4±3887.6)cm(mmH g)~2及(68647.5±2865.3)cm(mmH g)~2),对照组分别为(189.5±18.5)mmH g、(88.9±16.8)mmH g、(28986.6±3946.8)cm(mmH g)~2及(43462.9±3013.0)cm(mmH g)~2),两组比较差异有统计学意义(P<0.05);两组病人术后1年FACT-G评分均较术前明显改善,研究组变化更为显著(P<0.05)。结论 FTS理念可有效改善围术期低位直肠癌保肛手术病人的临床疗效,减少术后并发症,同时可显著改善病人的肛门括约肌功能。Objective To investigate the influence of fast track surgery on clinical effect,anal dynamics and living quality in treatment of low retcal cancer anus saving patients. Methods Screening100 cases of low retcal cancer anus saving patients as research subjects. According to a random number table method,100 cases were divided into twe group： study group（ 50 cases） and control group（ 50 cases）.Patients in control group were given traditional perioperative treatment,and patients in study group were given FTS perioperative treatment,then the two groups were compared in terms of the clinical effect and anal dynamics. Results There was no statistically significant difference in operation time between the two groups（ P〉0. 05）. The Intraoperative blood loss of study group and control group were（ 221. 4 ± 93. 1） ml and（ 263. 2 ± 76. 4） ml（ P〈0. 05）,first exhaust time after operation of the two group were（ 3. 7 ± 0. 6） d and（ 5. 6 ± 0. 8） d（ P〈0. 05）,intraoperative infusion volume of the two group were（ 2261. 5 ± 670. 2） ml and（ 2574. 2 ± 635. 0） ml（ P〈0. 05）,hospital stay after operation of the two group were（ 8. 5 ± 2. 1） d and（ 13. 2 ± 2. 0） d（ P〈0. 05）,first feeding time of the two group were（ 4. 1 ± 1. 2） d and（ 6. 6 ± 1. 8） d（ P〈0. 05）. The postoperative complication rate in study group（ 18. 0%） was lower than the control group（ 36. 0%）（ P〈0. 05）; 3 months after operation,the anal function good rate of the two group were 74. 0%and 54. 0%（ P〈0. 05）,anal maximum systolic blood pressure,anus maximum resting pressure,static vector volume and contraction vector volume of study group were（ 245. 2 ± 20. 1） mmH g,（ 165. 0 ± 17. 3）mmH g,（ 32792. 4 ± 3887. 6） cm（ mmH g）^2 and（ 68647. 5 ± 2865. 3） cm（ mmH g）^2）,respectively. While in control group were（ 189. 5 ± 18. 5） mmH g、（ 88. 9 ± 16. 8） mmH g、（ 28986. 6 ± 3946. 8） cm（ mmH g）^2 and（ 43462. 9 ± 3013. 0） cm

关 键 词：加速康复外科 低位直肠癌 保肛手术 肛门动力学 

分 类 号：R735.37[医药卫生—肿瘤]