加速康复外科在腹腔镜结肠次全切除联合改良Duhamel手术围术期的应用  

Safety and effectiveness of Enhanced recovery after surgery during laparoscopic subtotal Colonic resection with modified duhamel surgery

作　　者：刘子平 丁嘉宁 纪志鹏[1] 王金申[3] 李全辉[1] 臧义丰 汪天时 丁印鲁[1] LIU Zi-ping;DING Jia-ning;JI Zhi-peng;WANG Jin-shen;LI Quan-hui;ZANG Yi-feng;WANG Tian-shi;DING Yin-lu(Department of Gastrointestinal Surgery,Second Hospital of Shandong University (Jinan,250033,China);Queen Mary, Nanchang??University (Nanchang,330000,China);Department of Gastrointestinal Surgery,Shandong Provincial Hospital (Jinan,250021,China))

机构地区：[1]山东大学第二医院胃肠外科,山东 济南 250033 [2]南昌大学玛丽女王学院,江西 南昌 330000 [3]山东省立医院胃肠外科,山东 济南 250021

出　　处：《中国现代普通外科进展》2019年第4期280-283,共4页Chinese Journal of Current Advances in General Surgery

基　　金：山东省重点研发计划(2017G006007)

摘　　要：目的:通过腹腔镜结肠次全切除联合改良Duhamel手术治疗慢传输型便秘(STC),研究围手术期加速康复外科(ERAS)应用的安全性和有效性。方法:回顾性分析2014年1月-2018年1月期间27例重度慢传输型便秘,进行腹腔镜结肠次全切除联合改良Duhamel手术,随机分为两组:加速康复组(ERAS组)12例按加速康复外科理念进行围手术期治疗,对照组15例按传统理念行围手术期治疗。对两组结果进行比较并对分析。结果:ERAS组的离床时间、肠道功能恢复时间、自行排尿时间、进流食时间、术后营养状态较对照组均显著提前,术后住院时间缩短(P<0.05)。术后不良反应发生率ERAS组3例,对照组4例。结论:ERAS技术的应用能加速慢传输型便秘手术患者的术后康复。Objective: The purpose of the study is to investigate the safety and efficacy by applying with perioperative enhanced recovery after surgery(ERAS) of the clinical data of patients udergoing laparoscopic subtotal colectomy surgery combined with modified Duhamel for treatment of slow transit constipation(STC). Methods: A retrospective analysis of severe patients with functional constipation undergoing surgery from January 2014 to January 2018.27 cases undergoing laparoscopic subtotal colectomy surgery combined with modified Duhamel was confirmed.According to the difference between two ways of perioperative treatment,program is divided into two groups, 12 cases was in accelerated rehabilitation group(ERAS group) according to the concept of accelerated rehabilitation perioperative surgical treatment, and 15 cases was in the control group according to the traditional concept of the line perioperative treatment. Two sets of clinical data was statistical analyzed. Result:Compared with the control group, data form ERAS group-time away from the bed, bowel function recovery time,time until self-controled urinate,time on eating liquid diet,days in patient-were statistically significant(P<0.05). As to the incidence of adverse reactions after surgery, 3 cases were in ERAS group,and 4 cases were in the control group. Conclusion: Application of ERAS would accelerate rehabilitation of patients with STC after surgical, it’s worthy of clinical application.

关 键 词：改良Duhamel手术 加速康复外科 慢传输型便秘 

分 类 号：R574.62[医药卫生—消化系统]