中西医结合加速康复外科理念在胃癌全胃切除术后患者中的应用  

The Application of Accelerated Rehabilitation Surgery Concept of Integrated Traditional Chinese and Western Medicine in Patients with Gastric Cancer after Total Gastrectomy

作　　者：张旭[1] 林峰[1] 薛帆[1] 牟琳 孙冬莉[3] 刘文志[1] ZHANG Xu;LIN Feng;XUE Fan;MOU Lin;SUN Dongli;LIU Wenzhi(Department of Gastrointestinal Surgery,Zhongshan Hospital Affiliated to Dalian University,Liaoning Province,Dalian 116001,China;Department of Osteoporosis,Zhongshan Hospital Affiliated to Dalian University,Liaoning Province,Dalian 116001,China;Department of Gynecology,Zhongshan Hospital Affiliated to Dalian University,Liaoning Province,Dalian 116001,China)

机构地区：[1]大连大学附属中山医院胃肠外科,辽宁大连116001 [2]大连大学附属中山医院骨质疏松科,辽宁大连116001 [3]大连大学附属中山医院妇科,辽宁大连116001

出　　处：《中国中医药现代远程教育》2022年第14期129-132,共4页Chinese Medicine Modern Distance Education of China

基　　金：大连市卫生健康委员会医学科学研究计划项目【No.1711112】。

摘　　要：目的探讨中西医结合加速康复理念在全胃切除围手术期中的应用。方法按照纳入标准选取患者60例,随机分入中西医结合加速康复组(治疗组)及单纯加速康复组(对照组),各30例。观察指标包括2组术后恢复与并发症情况,以及围手术期应激反应及免疫功能指标。结果治疗组患者术后排气、排便时间较早(P<0.05),住院时间较短(P<0.05)。2组并发症总发生率及Clavien-DindoⅠ、Ⅱ级并发症发生率之间差异均无统计学意义(P>0.05)。2组术后第1天和第10天的CRP、IgA、IgG、IgM差异均无统计学意义(P>0.05),但治疗组术后第5天的CRP值明显低于对照组(P<0.05),并且IgA、IgG、IgM值明显高于对照组(均P<0.05)。结论中西医结合加速康复理念的应用在胃癌全胃切除术后促进胃肠功能恢复,缩短住院时间,改善术后早期应激反应、免疫功能方面优于单纯加速康复组。Objective To explore the application of integrated traditional Chinese and western medicine in accelerated rehabilitation surgery during perioperative period of total gastrectomy for gastric cancer.Methods According to the inclusion criteria,60 patients were enrolled and randomly divided into integrated traditional Chinese and western medicine and accelerated rehabilitation group(treatment group)and accelerated rehabilitation group(control group),with 30 patients in each group.The outcomes included postoperative recovery conditions and complications,perioperative stress response and immune function indexes were observed.Results The time of postoperative exsufflation and defecation was earlier(P<0.05),and the length of hospital stay was shorter(P<0.05)in the treatment group.There were no statistically significant differences in the overall postoperative morbidity,and the incidence of Clavien-Dindo grade I complications between the two groups(P>0.05).No significant differences were observed in CRP(C-reactive protein),IgA,IgG and IgM between the two groups on day 1 and day 10 after surgery(P>0.05),however,the CRP of the treatment group on day 5 after surgery was significantly lower than that of the control group(P<0.05),also the IgA,IgG and IgM were significantly higher than those of the control group(all P<0.05).Conclusion The combined application of integrated traditional Chinese and western medicine and accelerated rehabilitation concept were shown to be superior to accelerated rehabilitation alone in terms of promoting the recovery of gastrointestinal function,shortening hospital stay,and improving early postoperative stress response and immune function after total gastrectomy for gastric cancer.

关 键 词：康复理念 中西医结合 全胃切除 围手术期 胃癌 

分 类 号：R735.2[医药卫生—肿瘤] R493[医药卫生—临床医学]