enhanced recovery after surgery pancreas panereatoduodenecto

  本文关键词：加速康复外科理念用于胰十二指肠切除术临床研究，，由笔耕文化传播整理发布。

加速康复外科理念用于胰十二指肠切除术临床研究

Clinical study of enhanced recovery after surgery for pancreatoduodenectomy

[1] [2] [3] [4] [5] [6] [7]

LI Min, WANG Xin-bo, WANG Si-zhen, et al. （Department of General Surgery, Research Institute of General Surgery of PLA, Nanjing General Hospital of Nanjing Military Command o

南京军区南京总医院普通外科解放军普通外科研究所,江苏南京210002

文章摘要：目的探讨加速康复外科（ERAS）策略应用于行胰十二指肠切除术（PD）病人的安全性、可行性和有效性。方法回顾性分析2008年1月至2014年9月南京军区南京总医院普通外科收治的281例行PD病人的临床资料,根据治疗策略不同将病人分为ERAS组（90例,围手术期采用ERAS策略）和传统组（191例,围手术期按传统方法治疗）。对比分析两组病人术中及术后情况。结果 ERAS组与传统组的手术时间和术中出血量差异无统计学意义（P〉0.05）。ERAS组病人术后排气时间、排便时间、静脉补液时间、总住院时间及术后住院时间均缩短,术后进食时间和腹腔引流管拔除时间明显提前,与传统组差异均有统计学意义（P〈0.05）。两组病人术后总并发症发生率、各并发症发生率、病死率、再手术率以及再住院率差异均无统计学意义（P〉0.05）。ERAS组病人再次入院的原因是C级胰瘘（1例）、胃排空障碍（2例）和切口感染（1例）;传统组再次入院的原因为B级胰瘘（1例）、胃排空障碍（2例）、切口感染（1例）和肠梗阻（1例）。除C级胰瘘病人须行CT引导下穿刺引流术外,其余病人均通过保守治疗治愈。结论 ERAS策略可安全有效地应用于行PD病人,明显缩短术后住院时间,且不增高术后并发症发生率、病死率和再住院率。

Abstr：Objective To study the safety, feasibility and efficacy of enhanced recovery after surgery （ERAS） for pancreatoduodenectomy （PD） patients. Methods The clinical data of the 281 patients who underwent PD between January 2008 and September 2014 in Nanjing General Hospital of Nanjing Militancy Command of PLA were analyzed retrospectively. The patients were divided into ERAS （90 patients, treated with ERAS protocol） and conventional groups （191 patients, treated with conventional program） according to different treatments. The intraoperative and postoperative data were compared. Results There was no significant difference in operation time and operative blood loss between two groups （P〉0.05）. The days of first flatus, first stool and intravenous, length of stay （LOS） and LOS after operation in ERAS group were shorter than those in conventional group （P〈0.05）. Compared with conventional group, the patients in ERAS group had earlier food intake and drain removal （P〈0.05）. There was no significant difference in the rates of overall complication, special complication, relaparotomy, readmission and mortality between two groups （P〉0.05）. Four patients in ERAS group had readmission because of pancreatic fistula grade C （1 patient）, delayed gastric emptying （2 patients） and wound infection （1 patient）. Meanwhile, the number of readmission in conventional group was five （1 pancreatic fistula grade B, 2 delayed gastric emptying, 1 wound infection, 1 small bowel obstruction）. One patient who had pancreatic fistula grade C was treated with pereutaneous puncture draining guided by CT. The other readmitted patients were all cured with conservative treatment. Conclusion The ERAS pathway is feasible and safe for PD patients yielding a sh

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Keyword：:enhanced recovery after surgery pancreas panereatoduodenectomy

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  本文关键词：加速康复外科理念用于胰十二指肠切除术临床研究，由笔耕文化传播整理发布。