基层医院采用快速康复外科理念在胃癌围手术期中的研究  

Study on application of ERAS concept in perioperative period of gastric cancer in primary hospitals

作　　者：张昕 丁勇兴 王鹤仙 牛春申 李毅 王世杰 柏立山 张飞 李世邦 ZHANG Xin;DING Yong-xing;WANG He-xian(Department of Surgery,Affiliated Bengbu Third People's Hospital of Bengbu Medlical Collgeg,Anhui 233000,China)

机构地区：[1]蚌埠医学院附属蚌埠市第三人民医院普外科

出　　处：《淮海医药》2020年第1期21-24,共4页Journal of Huaihai Medicine

基　　金：蚌埠医学院自然科学基金(BYKY16150)

摘　　要：目的:探讨快速康复外科理念在胃癌围手术期应用的安全性和可靠性。方法:选取某院收治的胃癌患者,将其随机分为2组,ERAS组采用快速康复外科(ERAS)方案,传统组采用传统方案,2组均严格采用固定的主刀医师及护理团队。比较2组患者术后恢复情况和应激反应。结果:2组患者肛门排气时间、进半流质时间、住院时间、住院费用比较,差异有统计学意义(P<0.05),且ERAS组均优于传统组;2组患者术晨、术后第1天、术后第5天C反应蛋白、血皮质醇水平、术晨胰岛素抵抗指数比较,差异无统计学意义(P>0.05),2组患者术后第1天和术后第5天胰岛素抵抗指数比较,差异有统计学意义(P<0.05);2组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论:基层医院实行ERAS是可行的、安全的、有效的,并且可以为同级基层医院实行ERAS措施提供一定帮助和借鉴。Objective:To explore the safety and reliability of enhanced recovery after surgery(ERAS) concept in the perioperative period of gastric cancer.Methods:Patients with gastric cancer were randomly divided into two groups. One group used the ERAS program and the other group employed the traditional program. The two groups were strictly based on fixed surgeons and nursing team. The recovery and stress levels of the two groups were compared.Results:There were significant differences between the two groups in terms of the postoperative anal exhaust time,semi-fluid feeding time,postoperative hospital stay,and hospitalization costs(P<0.05),with the ERAS group being superior to the traditional group.On the first day and the fifth day after surgery there was no significant difference in C-reactive protein levels,blood cortisol levels or morning insulin resistance index between the two groups(P>0.05).The two groups were compared on the first day and the fifth day after surgery in terms of insulin resistance index and the difference was statistically significant(P<0.05). There was no statistically significant difference in the complications between the two groups.Conclusion:It is feasible, safe and effective to implement ERAS in primary hospitals, which can provide some help and reference for the implementation of ERAS measures in primary hospital at the same level.

关 键 词：胃肿瘤 围手术期 快速康复外科 基层医院 

分 类 号：R735.2[医药卫生—肿瘤]