加速康复外科在胃早癌行ESD治疗的有效性及安全性  

The safety and efficiacy of fast track surgery in early gastric cancer patients undergoing endoscopic submucosal dissection

作　　者：邢智远[1] 顾华勇[1] 戴锦朝[1] XING Zhi-yuan ;GU Hua-yong ;DAI Jin-chao(Department of Gastroinestinal Surgery,the Second Affiliated Hospital, Qingdao University Medical College, Qingdao, Shandong, 266000, China)

机构地区：[1]青岛大学医学院第二附属医院胃肠外科,山东青岛266000

出　　处：《临床消化病杂志》2018年第5期276-278,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]观察加速康复外科(FTS)治疗在胃早癌行内镜黏膜下剥离术(ESD)患者中的安全性和有效性。[方法]将72例行ESD治疗的胃早癌患者分为对照组与FTS组,每组36例。对照组采用传统的围手术期处理方法;FTS组采用FTS程序治疗,主要措施包括有效针对性宣教,缩短患者术前的禁食时间,术前口服含碳水化合物的液体,不放置鼻胃减压管,术中注意保温并控制入量,术后早期口服饮食,尽早下床活动等。观察比较2组手术及肛门恢复排气时间、术后住院时间、并发症发生及住院费用等情况。[结果]FTS组与对照组相比,术后住院时间缩短,治疗费用减少,术后肠排气时间提前,2组比较差异均有统计学意义。FTS组术后并发症的发生率并未增加。[结论]胃早癌患者按FTS理念治疗安全、有效,可以减少住院时间与治疗费用,加速患者的康复。[Objective]To investigate the safety and efficacy of fast track surgery（FTS）management in- early gastric cancer（EGC）undergoing endoscopic submucosal dissection（ESD）. [Methods]Seventy-two early gastric cancer patients undergoing endoscopic submucosal dissection were recruited prospectively. Patients were assigned to receive FTS management（n= 36）or conventional perioperative care（n=36） . The FTS care included pertinent explanation, shorten preoperative fasting time, no nasogastric decompressing tubes and abdominal drainage placed, early postoperative oral feeding, multimodal analgesia, and early mobilization. The length of postoperative hospital stay, medical cost, gut function, and postoperative complications in the two groups were recorded and compared. [Results]FTS group was associated with a significantly shorter postoperative hospital stay compared with conventional care group. Medical cost and duration of intravenous infusion was also shorter. First passage of flatus was earlier in FTS group than in conventional care group. There was no difference in morbidity or mortality between the two groups. [Con- clusion]FTS in early gastric cancer patients undergoing endoscopic submucosal dissection is safe and efficient, and it can shorten postoperative hospital stay and hasten return of gut function.

关 键 词：胃早癌 加速康复外科 内镜黏膜下剥离术 

分 类 号：R735.2[医药卫生—肿瘤]