加速康复外科理念在腹腔镜下胃癌根治术围术期的应用效果  

Application effect of enhanced recovery after surgery concept in perioperative period of laparoscopic radical gastrectomy for gastric cancer

作　　者：李威威 赵杰[1] 蔡峰 叶赛 LI Weiwei;ZHAO Jie;CAI Feng;YE Sai(the First People's Hospital of Shangqiu,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院,河南商丘476100

出　　处：《临床医学研究与实践》2024年第32期39-42,共4页Clinical Research and Practice

基　　金：2022年第二季度商丘市第一人民医院科研项目(No.YJ20220217)。

摘　　要：目的分析加速康复外科(ERAS)理念在腹腔镜下胃癌根治术围术期的应用效果。方法选择2020年7月至2023年7月商丘市第一人民医院收治的80例拟行腹腔镜手术的胃癌患者为研究对象,随机将其分为对照组与观察组,每组40例。对照组实施标准腹腔镜下胃癌根治术围术期处置,观察组实施基于ERAS理念的腹腔镜下胃癌根治术围术期处置。比较两组的干预效果。结果观察组的胃肠功能恢复时间、首次排气时间、首次进食时间、下床时间、住院时间短于对照组(P<0.05)。术后1 d,观察组的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)水平低于对照组(P<0.05)。术后1 d,观察组的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)低于对照组,体温高于对照组(P<0.05)。术后5 d,观察组的白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TRF)水平高于对照组,主观综合性营养评估(SGA)评分低于对照组(P<0.05)。结论ERAS理念在腹腔镜下胃癌根治术围术期的应用效果显著,可促进患者恢复,减轻炎症反应,改善术后营养状态,有助于患者更快进入后续治疗周期,值得推广。Objective To analyze the application effect of enhanced recovery after surgery(ERAS)concept in perioperative period of laparoscopic radical gastrectomy for gastric cancer.Methods A total of 80 patients with gastric cancer who underwent laparoscopic surgery in the First People's Hospital of Shangqiu from July 2020 to July 2023 were selected as the research objects and randomly divided into control group and observation group,with 40 cases in each group.The control group was given standard perioperative management of laparoscopic radical gastrectomy for gastric cancer,and the observation group was given perioperative management of laparoscopic radical gastrectomy for gastric cancer based on ERAS concept.The intervention effects of the two groups were compared.Results The recovery time of gastrointestinal function,the time of first exhaust,the time of first eating,the time of getting out of bed and the hospitalization time in the observation group were shorter than those in the control group(P<0.05).At 1 d after operation,the levels of interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)in the observation group were lower than those in the control group(P<0.05).At 1 d after operation,the mean arterial pressure(MAP),heart rate(HR)and respiratory rate(RR)of the observation group were lower than those of the control group,and the body temperature was higher than that of the control group(P<0.05).At 5 d after operation,the levels of albumin(ALB),prealbumin(PA)and transferrin(TRF)in the observation group were higher than those in the control group,and the Subjective Global Assessment(SGA)score was lower than that in the control group(P<0.05).Conclusion The ERAS concept in the perioperative period of laparoscopic radical gastrectomy for gastric cancer has a significant application effect.It can promote the recovery of patients,reduce the inflammatory response,improve the postoperative nutritional status,and help patients enter the follow-up treatment cycle faster,which is wor

关 键 词：腹腔镜 胃癌根治术 加速康复外科 营养状态 

分 类 号：R473.73[医药卫生—护理学]