加速康复外科理念在腹腔镜结直肠恶性肿瘤手术中的应用  

Application of the Idea of Enhanced Recovery After Surgery in the Operations for Colorectal Tumors

作　　者：李超[1] 徐靖[1] 张帅[1] 张巨东 武广海 赵永捷[1] LI Chao;XU Jing;ZHANG Shuai(Department of General Surgery,Tianjin Union Medical Center,Tianjin(300121),China)

机构地区：[1]天津市人民医院普通外科,天津300121

出　　处：《中国中西医结合外科杂志》2020年第6期1097-1100,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：天津市人民医院课题(2017YJ023,2017YJZD001)。

摘　　要：目的:探讨加速康复外科(ERAS)理念在结直肠恶性肿瘤患者腹腔镜手术围手术期实施的有效性和安全性。方法:将45例结直肠恶性肿瘤患者分为加速康复外科组(ERAS组)和对照组,其中ERAS组24例,围手术期采用加速康复外科方法处理,对照组21例,围手术期采用传统方法处理,比较两组在术后康复指标、疼痛评分及并发症等方面的差异。结果:两组患者年龄、性别、体质指数(BMI)等一般资料差异无统计学意义。与对照组相比,加速康复外科组患者术后首次排气时间提前[(2.71±0.23)d vs(4.17±0.15)d]、术后第1天血糖更稳定[(6.23±0.32)mmol/L vs(8.17±0.53)mmol/L]、术后第1天疼痛评分更低[(1.42±0.19)vs(2.75±0.18)]、导尿管留置时间缩短[(1.73±0.21)d vs(4.00±0.28)d]、腹腔引流管留置时间缩短[(4.14±0.23)d vs (7.69±0.31)d]、术后住院d数更短[(6.92±0.28)d vs(9.58±0.56)d],差异均有统计学意义(P<0.05),且并未增加术后并发症发生率。结论:以加速康复外科理念为基础的一系列治疗措施能够促进结直肠恶性肿瘤患者的术后康复。Objective To explore the effect and safety of administration of the idea of enhanced recovery after surgery(ERAS)in the operations for colorectal tumors.Methods 45cases of colorectal tumors were divided into the ERAS group(24 cases)and the control group(21 cases)randomly.The two groups were treated with ERAS measures and traditional measures respectively in perioperative period.The recovery indicators,pain scores and complications between the two groups were compared.Results There is no significant difference between the two groups on gender,age and BMI(P>0.05).Compared to the control group,the patients in the ERAS group recovered faster post operation with earlier exhaust time[(2.71±0.23)d vs(4.17±0.15)d],more stable blood glucose[(6.23±0.32)mmol/L vs(8.17±0.53)mmol/L],lower pain scores[(1.42±0.19)vs(2.75±0.18)],shorter period for indwelling of catheters[(1.73±0.21)d vs(4.00±0.28)d],drainage tubes[(4.14±0.23)d vs(7.69±0.31)d]and shorter hospital stays[(6.92±0.28)d vs(9.58±0.56)d].And the difference is significant(P<0.05).What's more,measures of ERAS didn't increase the complications after operations.Conclusion A series of measures based on the idea of ERAS can promote the recovery of patients after colorectal operations.

关 键 词：加速康复外科 结直肠恶性肿瘤 腹腔镜 围手术期 

分 类 号：R735.3[医药卫生—肿瘤]