ERAS在接受新辅助化疗的局部进展期胃癌患者围手术期应用效果分析  

Analysis of the effect of ERAS in the perioperative period of locally advanced gastric cancer patients receiving neoadjuvant chemotherapy

作　　者：曾繁利[1] 王东和[1] 杨贺庆[1] Zeng Fan-li;Wang Dong-he;Yang He-qing(General Surgery Department,The Second Hospital of Qinhiumgdao,Qinhiumgdao 066600,China)

机构地区：[1]秦皇岛市第二医院普通外科,秦皇岛066600

出　　处：《湖南师范大学学报（医学版）》2021年第1期46-49,共4页Journal of Hunan Normal University(Medical Sciences)

基　　金：2015年秦皇岛市科技支撑计划项目(201502A114)。

摘　　要：目的:探讨加速康复外科(ERAS)在接受新辅助化疗的局部进展期胃癌患者围手术期的临床应用价值。方法:选取从2015年5月~2018年5月秦皇岛市第二医院普外科收治的胃癌患者70例,随机分配至加速康复外科(ERAS)组和传统围手术期处理组(对照组),分别按两组处理程序进行围手术期管理,记录术后住院时间,手术并发症,肠功能恢复情况以及营养状况、CRP情况进行分析比较。结果:ERAS组术后并发症发生率(9.7%)与对照组(12.1%)无明显差异。ERAS组患者术后住院时间、首次排气时间以及恢复半流质饮食时间均短于对照组。术后第10天,ERAS组患者体重,血浆总蛋白,血浆白蛋白及前白蛋白较术前的降低程度均小于对照组,术后第1、3天ERAS组CRP水平升高程度小于对照组。结论:加速康复外科(ERAS)应用在接受新辅助化疗的局部进展期胃癌根治术患者围术期应用是安全可行的。不增加术后并发症,能减轻手术应激,缩短住院时间,改善患者营养状态,提高围手术期的生活质量。Objective To explore the clinical effect of enhanced recovery after surgery (ERAS) in perioperative period of Patients with advanced gastric cancer who received neoadjuvant chemotherapy.Methods From May 2015 to May 2018,70 patients who received neoadjuvant chemotherapy for locally advanced gastric cancer at qinhuangdao second hospital were randomized into ERAS and control group (patients undergoing standard perioperative management).Postoperative length of stay,complications,bowel function,and nutritional status were observed.Results There was no significant difference in the incidence of postoperative complications between the ERAS group (9.7%) and the control group (12.1%).The postoperative hospital stay,the first exhaust time and the time to restore a semi-liquid diet in the ERAS group were shorter than those in the control group.On the 10th day after the operation,the decrease in body weight,total plasma protein,plasma albumin and prealbumin of the ERAS group was less than that of the control group,and the increase in CRP level in the ERAS group was less than that of the control group on the 1st and 3rd day after operation.Conclusion ERAS is safe and feasible for the perioperative treatment of patients with advanced gastric cancer who received neoadjuvant chemotherapy.It could reduce the surgical stress,shorten the duration of hospital stay,improve nutritional status and quality of life without increasing postoperative complications.

关 键 词：加速康复外科 新辅助化疗 局部进展期胃癌 胃癌根治术 

分 类 号：R735.2[医药卫生—肿瘤]