胃癌术后早期经口进食安全性和有效性的临床观察

发布时间：2018-03-14 07:52

本文选题：胃癌术后　切入点：早期经口进食　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过回顾性研究分析探讨胃癌患者术后早期经口进食的安全性和有效性,为临床工作提供建议及依据。方法:收集54例在山西医科大学第一附属医院普外科同一治疗小组行胃癌根治术患者的临床资料,其中,于2016年6月一2017年4月期间收治的25例术后采取早期经口进食方案的患者设为早进食组,于2015年5月一2016年3月期间收治的29例术后采取传统治疗方案的患者设为传统组。比较两组患者在不同治疗方案下术后第七天的ALB、PAB水平、术后首次排气时间、进食后胃肠道耐受情况、术后并发症发生率及术后住院日等方面的差异。结果:1.两组患者的年龄、性别、体重指数、术前Hb、ALB、PAB、肿瘤分期、手术时间、手术出血量、手术方式均不具有统计学差异(p0.05)。2.术后第7天两组患者ALB水平无统计学差异(p0.05),早进食组患者PAB水平比传统组高,差异有统计学意义(p0.05)。3.术后首次排气时间早进食组早于传统组(p0.05);进食后胃肠道耐受情况及术后并发症发生率两组患者无统计学差异,(p0.05);术后住院日早进食组短于传统组(p0.05)。结论:腹腔镜胃癌根治术后早期经口进食与传统治疗方案相比,可以提高患者术后第七天的前白蛋白水平,缩短患者术后首次排气时间及术后住院日;同时患者胃肠道不耐受、吻合口出血、吻合口瘘、腹腔感染等相关并发症的风险并未增加。
[Abstract]:Objective: to investigate the safety and efficacy of oral feeding in early postoperative gastric cancer patients by retrospective analysis. Methods: the clinical data of 54 patients undergoing radical gastrectomy in general surgery department of the first affiliated Hospital of Shanxi Medical University were collected. From June 1st 2016 to April 2017, 25 patients with early oral feeding were treated as early feeding group. From May 1st 2015 to March 2016, 29 patients who received traditional treatment were divided into traditional group. The levels of ALB PAB and the time of first exhaust after operation were compared between the two groups at 7th days after operation under different treatment schemes. Results: 1. Age, sex, body mass index, preoperative HBO ALB PAB, tumor staging, operative time, and postoperative bleeding volume were significantly different between the two groups. On the 7th day after operation, there was no significant difference in ALB level between the two groups. The PAB level in the early eating group was higher than that in the traditional group. There was no significant difference between the two groups in the incidence of gastrointestinal tolerance and postoperative complications, and the early postoperative hospitalization time was shorter in the group of early intake of gas than in the traditional group (P 0.05), and the incidence of postoperative complications was not significantly different between the two groups in the first time of exhaust and in the group of early intake after operation (P 0.05), and there was no significant difference between the two groups in the incidence of postoperative complications. Conclusion: early oral feeding after laparoscopic radical gastrectomy is compared with traditional treatment. It can improve the prealbumin level of the patients 7th days after operation, shorten the first time of exhaust after operation and the days of hospitalization after operation, at the same time, the patients with gastrointestinal intolerance, anastomotic bleeding, anastomotic leakage, The risk of complications such as abdominal infection did not increase.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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