快速康复外科理念在全胃切除围手术期应用的临床研究

发布时间：2018-04-01 12:23

本文选题：快速康复外科(FTS)　切入点：胃癌　出处：《山西医科大学》2014年硕士论文

【摘要】：目的探讨快速康复外科(FTS)理念在胃癌行全胃切除围手术期应用的效果及其与传统围手术期治疗方法相比的优越性。方法选取山西医科大学附属晋煤集团总医院从2012年6月至2014年3月间,胃癌患者行全胃切除术30例作为FTS组,另选取同期胃癌患者行全胃切除术围手术期使用传统方法30例作为对照组。两组患者的手术操作和麻醉均由同一组外科医师和同一组麻醉师进行。分析FTS组和传统组在手术相关指标(手术时间、术中出血量、术后第3天C反应蛋白水平、引流管拔管时间)和术后恢复指标(肺部感染、肠鸣音恢复时间、首次排气恢复时间、静脉输液天数,术后并发症、住院时间、费用及术后2周体重减轻量)的异同。结果两组病人均痊愈出院,FTS治疗组与传统方法治疗组相比,术后首次排气时间、肠鸣音恢复时间均明显提前,静脉输液天数、术后两周体重减轻量、住院费用及住院时间、术后并发症均明显减少(P0.05)；FTS对应激的改善作用优于传统方法,但两组肺部感染比较无明显差异(P0.05)。结论1.应用FTS理念于胃癌行全胃切除患者围手术期是安全的,可有效促进患者术后康复,减少术后并发症发生； 2.与传统围手术期方法比较,全胃切除应用FTS理念,可提高患者满意度,减轻患者围手术期的创伤和应激反应,减轻患者围手术期的痛苦,促进患者的早期康复。缩短患者住院时间、减少术后并发症、改善患者术后器官功能、降低治疗费用、加快床位的周转率。
[Abstract]:Objective to investigate the effect of fast rehabilitation surgery (FTS) in the perioperative period of total gastrectomy for gastric cancer and its superiority compared with the traditional perioperative treatment. Methods from June 2012 to March 2014, 30 patients with gastric cancer underwent total gastrectomy as FTS group. In addition, 30 patients with gastric cancer undergoing total gastrectomy during perioperative period were selected as control group. The operation and anaesthesia of the two groups were performed by the same group of surgeons and anesthesiologists. The FTS group and the transmission group were analyzed. The related indexes of operation (operation time, operation time, Blood loss during operation, C-reactive protein level on the 3rd day after operation, drainage tube extubation time) and postoperative recovery indexes (pulmonary infection, recovery time of bowel sound, time of first exhaust recovery, days of intravenous infusion, postoperative complications, hospitalization time), Cost and weight loss 2 weeks after operation) similarities and differences. Results compared with the traditional treatment group, the first exhaust time and the recovery time of the bowel sound in the FTS treatment group were significantly earlier than those in the traditional treatment group. The days of intravenous infusion, weight loss, hospitalization cost and hospitalization time were also observed in the two groups. The effect of FTS on stress was better than that of traditional methods, but there was no significant difference in pulmonary infection between the two groups. Conclusion 1. It is safe to apply FTS concept to the patients with gastric cancer undergoing total gastrectomy, which can effectively promote postoperative rehabilitation and reduce postoperative complications. 2. 2.Compared with the traditional perioperative method, the application of FTS in total gastrectomy can improve the patients' satisfaction, reduce the trauma and stress response of the patients during perioperative period, and relieve the pain of the patients during perioperative period. To promote the early rehabilitation of patients, shorten the hospitalization time, reduce postoperative complications, improve postoperative organ function, reduce the cost of treatment, speed up the rate of bed turnover.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R735.2

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