加速康复外科在腹腔镜结直肠癌根治术中的应用

发布时间：2019-03-04 20:07

【摘要】：目的:分析和研究在高原地区,将加速康复外科应用于腹腔镜结直肠癌手术的有效性和安全性。方法:收集2015年10月-2016年10月期间于青海大学附属医院胃肠外科接受腹腔镜结直肠癌根治术患者,符合标准的一共80例,其中在与手术相关的时期给予加速康复治疗方案的患者为研究组,共41例;在与手术相关的时期给予传统常规治疗方案的患者为对照组,共39例。通过分析和比较两组患者在手术的安全性和手术的有效性之间的差异。结果:两组年龄,性别,ASA分级,肿瘤位置及分期,慢性合并症等差异无统计学意义(P0.05),具有一定可比性。两组平均手术时间没有明显差异(P0.05)。加速康复组的患者术后排气时间比对照组的时间短,在平均住院时间、总的住院费用方面,加速康复组要比对照组的低,两组差异有统计学意义(P0.05)。两组患者,术后均平稳恢复,并且康复出院。加速康复组术后并发症发生率低,两组差异有统计学意义(P0.05)。两组均未出现环周切缘阳性例数,无肿瘤残留;两组平均清扫淋巴结数目方面差异无统计学意义(P0.05)。结论:1.加速康复外科方案联合腹腔镜结直肠癌手术是有效的。2.加速康复外科方案联合腹腔镜结直肠癌手术是安全的。3.在高原地区推广和应用加速康复外科可以取得良好的社会经济效益。
[Abstract]:Objective: to analyze and study the efficacy and safety of accelerated rehabilitation surgery in laparoscopic colorectal cancer surgery at high altitude. Methods: from October 2015 to October 2016, 80 patients who received laparoscopic radical resection of colorectal cancer in the Department of Gastroenterology, affiliated Hospital of Qinghai University, were collected. The patients who were given accelerated rehabilitation therapy in the period related to surgery were the study group (n = 41). A total of 39 patients were treated with conventional therapy during the operation-related period (n = 39). The difference between safety and effectiveness of operation was analyzed and compared between the two groups. Results: there was no significant difference in age, sex, ASA grade, tumor location and stage, chronic complication between the two groups (P0.05). There was no significant difference in the average operative time between the two groups (P0.05). In the average hospitalization time and the total hospitalization cost, the accelerated rehabilitation group was lower than the control group, and the difference between the two groups was statistically significant (P0.05). The patients in both groups recovered smoothly after operation and were discharged from hospital. The rate of postoperative complications in accelerated rehabilitation group was lower, and there was significant difference between the two groups (P0.05). There was no significant difference in the number of positive circumferential margin and tumor residue between the two groups, and there was no significant difference in the average number of lymph node dissection between the two groups (P0.05). Conclusions: 1. Accelerated rehabilitation surgery combined with laparoscopic colorectal cancer surgery is effective. 2. Accelerated rehabilitation surgery combined with laparoscopic colorectal cancer surgery is safe. 3. The promotion and application of accelerated rehabilitation surgery in plateau areas can achieve good socio-economic benefits.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34

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