围术期应用加速康复外科在腹腔镜直肠癌经括约肌间切除术患者中的临床效果  

Effects of enhanced recovery after surgery in perioperative period of laparoscopic intersphincteric resection of rectal cancer

作　　者：孙文 殷燕[1] 段静 SUN Wen;YIN Yan;DUAN Jing(Department of Colorectal and Anal Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院结直肠肛门外科

出　　处：《中国医学前沿杂志（电子版）》2020年第2期44-48,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨围术期加速康复外科(enhanced recovery after surgery,ERAS)在腹腔镜直肠癌经括约肌间切除术(intersphincteric resection,ISR)患者中的应用效果。方法选取2017年9月至2019年9月于武汉大学中南医院行ISR的86例低位直肠癌患者为研究对象,按照随机数表法将所有患者分为观察组和对照组,每组各43例。对照组患者采用常规围术期干预,观察组患者在围术期接受ERAS综合干预。比较两组患者术后恢复情况、并发症发生率、术后生存质量及出院时患者的临床满意度。结果观察组患者首次排气时间、首次排便时间、住院天数均显著短于对照组(均P<0.05),住院费用显著低于对照组(P<0.05);观察组患者术后世界卫生组织生存质量测定量表简表生理、心理领域评分均显著高于对照组(均P<0.05);出院时,观察组患者的临床满意度显著高于对照组(P<0.05)。结论围术期实施ERAS干预在腹腔镜辅助ISR患者中的应用效果令人满意,能显著促进患者术后康复,提高生存质量与临床满意度,值得推广应用。Objective To investigate the effects of enhanced recovery after surgery(ERAS)in perioperative period of laparoscopic intersp hincteric resection(ISR)of rectal cancer.Method Eighty-six patients with low rectal cancer who underwent selective laparoscopic ISR from September 2017 to September 2019 in Zhongnan Hospital of Wuhan University were enrolled in the study and they were randomly divided into observation group and control group,each group has 43 patients.Patients in control group were given routine perioperative interv ention,while patients in observation group were given ERAS comprehensive intervention during perioperative period.The recovery index,incidence of complications,postoperative quality of life and clinical satisfaction at discharge were compared between the two groups.Result The first exhaust time,first defecation time,hospitalization days and expenses in observation group were significantly lower than those in control group(all P<0.05),the costs in hospital in observation group is significantly lower than that in control group(P<0.05).The scores of physiological and psychological fields of brief version of World Health Organization quality of life in observation group were significantly higher than those in control group(all P<0.05),and the clinical satisfaction was significantly higher than that in control group(P<0.05).Conclusion ERAS intervention during perioperative period in patients underwent laparoscopic ISR for rectal cancer is satisfactory.It could significantly promote recovery after operation,improve the quality of life and clinical satisfaction of patients,which is worth popularizing and applying.

关 键 词：加速康复外科 腹腔镜 经括约肌间切除术 围术期 术后康复 直肠癌 

分 类 号：R735.37[医药卫生—肿瘤]