加速康复外科在胆囊癌根治手术中的应用  

Application of enhanced recovery after surgery in radical surgery of gallbladder cancer

作　　者：王荇 张云[1] 张淼[1] WANG Xing;ZHANG Yun;ZHANG Miao(Department of General Surgery,Yixing People's Hospital,Yixing 214200,China)

机构地区：[1]宜兴市人民医院

出　　处：《腹腔镜外科杂志》2020年第2期129-133,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨加速康复外科理念(ERAS)在胆囊癌根治术中的应用价值。方法:选取2013年1月至2018年12月行胆囊癌根治术的50例患者为研究对象,按围手术期是否采用加速康复外科处理措施分为实验组(n=25)与对照组(n=25),比较两组手术时间、术中出血量、术毕转入ICU例数、术后肛门排气时间、术后进食时间、下床活动时间、引流管拔除时间、住院时间、住院费用、疼痛评分、术后肿瘤复发转移率、病死率及胆漏、腹腔出血、切口感染、肺部感染等并发症情况。结果:实验组术后肛门排气时间、术后进食时间、下床活动时间、引流管拔除时间、住院时间、住院费用、疼痛评分均优于对照组,差异有统计学意义(P<0.05);两组手术时间、术中出血量、术毕转入ICU例数差异无统计学意义(P>0.05);两组术后胆漏、腹腔出血、切口感染、肺部感染情况差异亦无统计学意义(P>0.05)。随访期内,两组肿瘤复发转移率、死亡率差异无统计学意义(P>0.05)。结论:加速康复外科理念在胆囊癌根治术中具有不影响原有疗效,但可减轻患者痛苦、减少创伤、加速康复的重要价值。Objective:To explore the application value of enhanced recovery after surgery(ERAS) in radical operation of gallbladder cancer.Methods:A total of 50 patients receiving radical operation of gallbladder cancer from Jan.2013 to Dec.2018 were divided into experimental group(n=25) and control group(n=25) according to whether they were treated with ERAS measures during the perioperative period.The clinical indicators of the two groups were compared.Results:Compared with the control group,the postoperative anal exhaust time,feeding time,time of ambulation,removal of drainage tube time,hospitalization time,hospitalization cost and pain score were significantly lower in ERAS group,the differences were statistically significant(P<0.05).There were no significant differences in operative time,intraoperative blood loss or the number of cases transferred to ICU after surgery between the two groups(P>0.05).There were no significant differences in incidence of postoperative bile leakage,abdominal bleeding,incision infection or pulmonary infection between the two groups(P>0.05).There were no significant differences in incidence of tumor recurrence,metastasis or death during the follow-up period between the two groups(P>0.05).Conclusions:The concept of ERAS in radical operation of gallbladder cancer has important value including reducing the pain of patients,reducing trauma and accelerating the recovery of patients without affecting original curative effect.

关 键 词：胆囊肿瘤 胆囊癌根治术 加速康复外科 

分 类 号：R657.4[医药卫生—外科学]