加速康复外科在腹腔镜结直肠癌手术围手术期的应用研究  

The Application of Enhance Recovery after Surgery in Perioperative Period of Laparoscopic Colorectal Surgery

作　　者：朱州[1] 钟晓刚[1] 秦俭[2] ZHU Zhou;ZHONG Xiao-gang;QIN Jian(Department of Gastrointestinal Surgery,People~ Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China;Department of Radiotherapy,People＇s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China)

机构地区：[1]广西壮族自治区人民医院胃肠外科,南宁530021 [2]广西壮族自治区人民医院放疗科,南宁530021

出　　处：《中国现代手术学杂志》2018年第2期122-125,共4页Chinese Journal of Modern Operative Surgery

基　　金：广西自然科学基金项目(编号:2016GXNSFAA380106)

摘　　要：目的观察加速康复外科(enhance recovery after surgery,ERAS)对腹腔镜结直肠癌根治术患者机体术后康复的影响。方法将106例腹腔镜结直肠癌根治术患者随机分成常规组(n=54)和加速康复组(n=52)。观察手术时间、术中出血量、术后首次排气时间、首次排便时间、进食时间和拔除导尿管时间、术后疼痛评分、术后吻合口瘘、肺部感染、腹腔感染、肠梗阻等并发症的发生率。结果两组手术时间和术中出血量无明显差异(P>0.05)。术后首次排气和排便时间、进食时间、拔除尿管时间、疼痛评分,常规组较对照组长(P<0.05)。而术后吻合口瘘、肺部感染、腹腔感染和肠梗阻等并发症的发生率,两组无差异(P﹥0.05)。结论结直肠癌患者应用EARS理念行腹腔镜手术,可更有效地缓解术后的炎性反应,减轻分解代谢,促进患者胃肠功能恢复,对患者术后的加速康复起到了积极的作用。Objective To observe the effect of enhance recovery after surgery（ ERAS） on the postoperative rehabilitation in the patients undergoing laparoscopic radical surgery for colorectal cancer. Methods106 patients with laparoscopic radical resection of colorectal cancer were randomly divided into the conventional group（ n = 54） and the ERAS group（ n = 52）. It was compared in the aspects of the first postoperative anal exhaust time,the first defecation time,feeding time and catheter removal time,postoperative pain score,and complications,such as postoperative anastomotic leakage,pulmonary infection,abdominal infection and intestinal obstruction. Results There was no significant difference in operation time and the hemorrhage volume.But time of the first anal exhaust and defecation,time of feeding,time of catheter removal,and the pain score of the ERAS group were all better than that of the conventional group（ P〈0. 05）. There was no difference in the complication rate（ P〈0. 05）. Conclusion The EARS concept using in the laparoscopic radical surgery for patients with colorectal cancer can relieve postoperative inflammatory reactions more effectively,reduce catabolism,and promote the recovery of the gastrointestinal function,which plays a positive role in the accelerated recovery after surgery.

关 键 词：加速康复外科 结直肠肿瘤 

分 类 号：R735.3[医药卫生—肿瘤] R656.9[医药卫生—临床医学]