加速康复外科在腹腔镜胃癌手术中的应用  

Application of enhanced recovery after surgery in laparoscopic gastric cancer surgery

作　　者：陈锐[1] 蒋玭露 周申康[1] 陈建辉 CHEN Rui;JIANG Pinlu;ZHOU Shenkang;CHEN Jianhui(Department of Gastrointestinal Surgery,Taizhou Hospital of Zhejiang Province,Linhai317000,China)

机构地区：[1]浙江省台州医院胃肠外科,浙江临海317000

出　　处：《中国现代医生》2020年第17期87-91,共5页China Modern Doctor

基　　金：浙江省自然科学基金资助项目(LGF19H160017)。

摘　　要：目的探讨加速康复外科(Enhanced recovery after surgery,ERAS)在腹腔镜胃癌根治术中的具体应用。方法回顾性分析2015年1月~2018年6月在台州医院胃肠外科手术治疗的279例胃癌患者临床资料,所有病例均行腹腔镜胃癌D2根治术,其中122例应用加速康复外科理念治疗(ERAS组),157例按照传统围手术期治疗方案(传统组),比较两组手术时间、术中出血量、肛门排气时间、术后进食时间、平均住院费用、平均住院时间、引流管数量、术后30 d内并发症及非计划再住院发生状况。结果ERAS组与传统组患者手术时间、术中出血量比较无显著性差异(P>0.05)。相比于传统组患者,ERAS组患者肛门排气时间缩短,术后进食时间提前,平均住院费用下降,平均住院时间缩短,引流管数量减少(P<0.05)。ERAS组与传统组患者30 d内并发症发生率、30 d内非计划再住院率比较,差异无统计学意义(P>0.05)。结论腹腔镜胃癌手术应用ERAS是安全、有效的,有助于加速患者康复。Objective To explore the specific application of enhanced recovery after surgery(ERAS)in laparoscopic radical surgery for gastric cancer.Methods The clinical data of 279 patients with gastric cancer who underwent surgery in department of gastrointestinal surgery in Taizhou Hospital from January 2015 to June 2018 were retrospectively analyzed.All patients underwent laparoscopic D2 radical surgery for gastric cancer.122 patients were treated according to enhanced recovery after surgery(ERAS group).157 patients were treated according to the traditional perioperative treatment plan(traditional group).The operation time,intraoperative blood loss,anal exhaust time,postoperative eating time,average hospitalization cost,average hospitalization time,the number of drainage tubes,complications and the status of unplanned rehospitalization within 30 days after surgery were compared.Results There was no significant difference in the operation time and intraoperative blood loss between the ERAS group and the traditional group(P>0.05).Compared with the traditional group,the ERAS group had shorter anal exhaust time,earlier postoperative feeding time,lower average hospitalization costs,shorter average hospitalization time,and fewer drainage tubes(P<0.05).There was no significant difference in the incidence of complications and the rate of unplanned rehospitalization within 30 days between the ERAS group and the traditional group(P>0.05).Conclusion The application of ERAS in laparoscopic gastric cancer surgery is safe and effective,which can help accelerate the recovery of patients.

关 键 词：加速康复外科 腹腔镜胃癌手术 胃癌根治术 循证医学 

分 类 号：R735.2[医药卫生—肿瘤]