快速康复外科对早期胃癌腹腔镜辅助保留幽门胃切除术患者营养状态的影响分析  

Analysis of the effect of rapid rehabilitation surgery on the nutritional status of patients undergoing laparoscopic-assisted pyloric sparing gastrectomy for early gastric cancer

作　　者：李宗富[1] 陈铁良 丁梅 王增辉[2] 陈建利 LI Zongfu;CHEN Tieliang;DING Mei(Department of Clinical Medicine,Tangshan Vocational and Technical College,Hebei,Tangshan 063000,China;不详)

机构地区：[1]河北省唐山职业技术学院临床医学系外科教研室,063000 [2]唐山市协和医院普外一科 [3]华北理工大学附属医院普外科

出　　处：《临床外科杂志》2022年第5期433-436,共4页Journal of Clinical Surgery

摘　　要：目的探讨快速康复外科对早期胃癌腹腔镜辅助保留幽门胃切除术病人营养状态的影响。方法2014年3月~2018年8月在我院确诊并行早期胃癌腹腔镜辅助保留幽门胃切除术的早期胃癌病人80例,根据是否实施快速康复外科,分为对照组(48例)和观察组(32例),对照组病人采用传统外科诊疗方案,观察组病人实施快速康复外科治疗方案,观察记录两组病人术后恢复情况(住院时间、首次排气时间、胃管拔除时间、恢复流质饮食时间以及排便时间)、术后营养状况[白蛋白(ALB)、前白蛋白(PAB)、血红蛋白(HB)水平]、以及随访情况(生活质量、并发症发生率以及生存率)。结果观察组术后住院时间、首次排气时间、胃管拔除时间、恢复流质饮食时间以及排便时间均短于对照组,差异有统计学意义(P<0.05);术前两组病人主观整体营养状况评量表(patient-generated subjective global assessment,PG-SGA)评分差异无统计学意义(P>0.05),术后14天两组病人PG-SGA评分均有所降低,但观察组病人PG-SGA评分降低更明显,差异有统计学意义(P<0.05),术后30天,观察组PG-SGA评分低于对照组,差异有统计学意义(P<0.05),术前两组病人ALB、PAB、HB水平无明显差异(P>0.05),术后7天两组病人ALB、PAB、HB显著降低,但对照组病人PAB降低更明显,差异有统计学意义(P<0.05),术后14天两组病人ALB、PAB、HB较术后7天均有所回升,且观察组ALB、PAB、HB水平高于对照组,差异有统计学意义(P<0.05);术后随访发现,观察组Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级、Ⅴ级并发症发生率分别为15.63%、40.63%、6.25%、3.13%和3.13%,低于对照组的16.67%、50.00%、8.33%、6.25%和4.17%,差异有统计学意义(P<0.05)。结论快速康复外科可以加速病人术后康复,减少住院时间,术后病人营养水平恢复更快,有利于病情恢复。Objective To explore the effect of rapid rehabilitation surgery on the nutritional status of patients undergoing laparoscopic-assisted pyloric sparing gastrectomy for early gastric cancer.Methods A retrospective selection of 80 patients with early gastric cancer who were diagnosed in our hospital from March 2014 to August 2018 and combined with early gastric cancer laparoscopic-assisted pyloric sparing gastrectomy were used as research data.According to whether or not rapid rehabilitation surgery was performed,they were divided into control group(48 cases)and observation group(32 cases),among them,the traditional surgical diagnosis and treatment plan for the control group,the rapid rehabilitation surgical treatment plan for the observation group,and observe and record the postoperative recovery of the two groups of patients(hospitalization time,first exhaust time,gastric tube removal time,and liquid diet recovery time And defecation time),postoperative nutritional status(ALB,PAB,HB level),and follow-up status(quality of life,complication rate,and survival rate).Results Postoperative hospitalization time,first exhaust time,gastric tube removal time,restoring liquid diet time,and defecation time in the observation group were shorter than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the scorespreoperative PG-SGA in the two groups(P>0.05).The PG-SGA scores of the two groups of patients decreased after 14 days,but the PG-SGA scores of patients in the observation group decreased more significantly,and the difference was statistically significant(P<0.05).After 30 days,the PG-SGA score of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the levels of ALB,PAB,and HB between the two groups before surgery(P>0.05).The level of ALB,PAB,and HB were significantly reduced in the two groups at 7 days after surgery,but the level of

关 键 词：快速康复外科 早期胃癌 腹腔镜 胃切除术 营养状态 预后 

分 类 号：R735.2[医药卫生—肿瘤]