加速康复外科对肝癌术后长期生存的影响  

Effects of fast enhanced recovery after surgery(ERAS) on long-term survival of patients with liver cancer

作　　者：章旭峰 黄丽丽[1] 唐成武[1] ZHANG Xufeng;HUANG Lili;TANG Chengwu(Department of Surgery, the First People's Hospital of Huzhou City in Zhejiang Province,Huzhou 313000,China)

机构地区：[1]浙江省湖州市第一人民医院外科

出　　处：《中国现代医生》2019年第18期132-135,共4页China Modern Doctor

基　　金：浙江省分析测试和实验动物计划项目(2018C37088)

摘　　要：目的探讨加速康复外科肝癌患者术后长期生存的影响。方法选取于2013年7月~2015年7月间在本院行开放手术治疗76例肝癌患者,其中37例患者接受加速康复外科治疗措施(ERAS组),其余39例患者接受常规治疗措施(对照组)。比较两组患者术后长期生存率。结果在术后3年内,对照组有19例复发,无复发生存率为51.28%(20/39);而ERAS组有16例复发,无复发生存率为56.76%(21/37),故两组3年无复发生存率无显著差异(P=0.5163;风险比:1.2433;95%CI:0.6408~2.4123)。在术后3年内,对照组有14例死亡,3年总生存率为64.10%(25/39);而ERAS组有12例死亡,3年总生存率为67.57%(25/37),故两组3年总生存率比较无显著差异(P=0.8006;风险比:1.1035;95%CI:0.5114~2.3812)。结论加速康复外科措施应用于肝癌患者围手术期,不会对其术后长期生存产生不利影响。Objective To explore the effects of enhanced recovery after surgery(ERAS) on long-term survival of patients with liver cancer. Methods From July 2013 to July 2015, 76 patients with liver cancer were given open surgery in our hospital, and 37 cases of them were treated with enhanced recovery after surgery(ERAS) while the remaining 39 patients received routine care(control group). Long-term survival was compared between the two groups. Results Within three years after surgery, 19 patients in the control group had a relapse with a relapse-free survival rate of 51.28%(20/39). In the ERAS group, 16 patients had a relapse, and the relapse-free survival rate was 56.76%(21/37). There was no significant difference in 3-year relapse-free survival rate between the two groups( P=0.5163;hazard ratio: 1.2433;95%CI: 0.6408-2.4123). During three years after surgery, control group had 14 deaths with a 3-year overall survival rate of64.10%(25/39);ERAS group had 12 deaths with 3-year overall survival rate of 67.57%(25/37). No significant difference was observed in the 3-year overall survival rate between the two groups( P =0.8006;hazard ratio:1.1035;95% CI:0.5114-2.3812). Conclusion Application of ERAS into the perioperative period of liver cancer has no adverse effect on patients’ long-term survival after surgery.

关 键 词：肝癌 加速康复外科 肝切除 长期生存率 围手术期 

分 类 号：R657.3[医药卫生—外科学]