加速康复外科在直肠癌腹会阴联合切除术中的应用  

Implementation of enhanced recovery after surgery in abdominoperineal resection of rectal cancer

作　　者：王海锋 王刚 赵健 刘江 周嘉晖 江志伟 WANG Haifeng;WANG Gang;ZHAO Jian;LIU Jiang;ZHOU Jiahui;JIANG Zhiwei(Research Institute of General Surgery,Jinling Hospital,Medical School of Nanjing University,Nanjing 210002,Jiangsu,China)

机构地区：[1]南京大学医学院附属金陵医院普通外科研究所

出　　处：《山东大学学报（医学版）》2019年第9期33-37,共5页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81500417);江苏省社会发展项目(BE2015687)

摘　　要：目的探讨加速康复外科(ERAS)在直肠癌腹会阴联合切除术(APR)围手术期应用的安全性及有效性。方法回顾性分析2015年2月至2017年8月接受APR的80例直肠癌患者病历资料,其中40例患者实施ERAS围手术期处理措施(加速康复组),另40例实施传统围手术期处理措施(传统组)。观察比较两组术后视觉模拟评分法(VAS)疼痛评分、首次进食时间、肠功能恢复时间、首次下床活动时间、停止静脉输液时间、术后住院时间及术后并发症发生情况。结果加速康复组术后1~3 d VAS疼痛评分均低于传统组。加速康复组术后首次进食时间、肠功能恢复时间、首次下床活动时间、停止静脉输液时间及术后住院时间短于传统组,差异均具有统计学意义(P<0.05)。加速康复组术后会阴部切口并发症发生率为5%,低于传统组的15%(P=0.018)。结论ERAS在直肠癌腹会阴联合切除术围手术期的应用是安全有效的,可显著缩短患者术后住院时间,降低术后会阴部切口并发症发生率。Objective To explore the safety and efficacy of enhanced recovery after surgery(ERAS)for patients with rectal cancer treated with abdominoperineal resection(APR).Methods A retrospectivereview of 80 rectal cancer patients who underwent APR at Jinling Hospital during Feb.2015 and Aug.2017 was conducted.The patients were divided into ERAS group(n=40)and traditional group(n=40).The postoperative pain,eating time,intestinal function recovery time,ambulation time,stop intravenous infusion time,postoperative hospital stay and postoperative complication in the two groups were observed and compared.Results ERAS group had lower VAS pain score,earlier oral feeding and intestinal function recovery,shorter ambulation and intravenous infusion time,and shorter hospital stay than the traditional group.Postoperative perineal wound complication rate reached 15%in the traditional group,which was significantly higher than the 5%in the ERAS group(P=0.018).Conclusion ERAS is feasible and effective for rectal cancer patients undergoing APR,which can significantly shorten the postoperative hospital stay,and reduce the incidence of perineal wound complications.

关 键 词：加速康复外科 直肠癌 经腹会阴联合切除术 

分 类 号：R619[医药卫生—外科学]