加速康复外科在腹腔镜辅助远端胃癌根治术中的效果评价

发布时间：2018-04-10 02:22

本文选题：远端胃癌　切入点：腹腔镜辅助　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:评价在加速康复外科(Enhanced recovery after surgery ERAS)指导下的腹腔镜辅助远端胃癌根治术的可行性和有效性。方法:选取山西省肿瘤医院2016年4月至2016年11月符合条件择期行远端胃癌手术的患者,按入院时间的先后随机单双编号,奇数纳入传统处理组,偶数纳入加速康复组,共纳入60例患者,其中,传统处理组30例,加速康复组30例。分别记录两组患者的术前相关资料:年龄、性别、体重、BMI、术前1天血清白蛋白水平(ALB);手术相关的资料:手术时间、吻合方式、术中总出血量;术后相关资料:术后两组患者的TNM分期、术后肛门排气时间、术后住院时间、住院总费用、并发症发生情况、术后第4天、第7天血清白蛋白水平。并对两组数据进行统计学分析、比较。结果:两组患者间的年龄、性别、体重、BMI、术前1天ALB水平、手术时间、吻合方式、术中总出血量、术后患者的TNM分期、并发症发生情况均无显著性差异(P均0.05);术后ALB水平ERAS组较传统组高,且变化更平稳、术后肛门排气时间ERAS组较传统组快、住院总费用ERAS组较传统组少,差异均有统计学意义(P均0.05);术后平均住院时间ERAS组(8.87±1.80天)较传统组(9.47±1.52天)略短,但比较无统计学意义(P0.05)。结论:1.两组患者相比较,ERAS组较传统组在减轻患者的应激反应、促进胃肠道功能恢复、降低住院费用等方面有一定的优势。2.ERAS理念应用于腹腔镜辅助远端胃癌根治术中是安全、可靠的。
[Abstract]:Objective: to evaluate the feasibility and effectiveness of laparoscopic assisted radical gastrectomy for distal gastric cancer under the guidance of accelerated recovery after surgery ERASA.Methods: patients with distal gastric cancer were selected from April 2016 to November 2016 in Shanxi Cancer Hospital. According to the time of admission, the patients were assigned to the traditional treatment group with odd number, and even number into the accelerated rehabilitation group.A total of 60 patients were included, including 30 cases in traditional treatment group and 30 cases in accelerated rehabilitation group.The preoperative data of the two groups were recorded: age, sex, body weight, serum albumin level and ALBX on one day before operation, operation time, anastomosis mode, total blood loss during operation;Postoperative data: TNM stage, postoperative anal exhaust time, postoperative hospitalization time, total cost of hospitalization, complications, serum albumin level on the 4th and 7th day after operation in the two groups.And the two groups of data were statistically analyzed and compared.Results: age, sex, body weight, preoperative ALB level, operation time, anastomosis mode, total blood loss during operation, TNM staging of the patients after operation were compared between the two groups.The postoperative ALB level in ERAS group was higher than that in traditional group, and the change was more stable. The postoperative anal exhaust time in ERAS group was faster than that in traditional group, and the total cost of hospitalization in ERAS group was less than that in traditional group.The average postoperative hospitalization time in ERAS group was 8.87 卤1.80 days, which was slightly shorter than that in traditional group (9.47 卤1.52 days), but there was no significant difference between the two groups.Conclusion 1.Compared with the traditional group, the ERAS group has some advantages in reducing the stress response, promoting the recovery of gastrointestinal function and reducing the cost of hospitalization. 2. It is safe and reliable to apply the ERAS concept in laparoscopic assisted distal gastric cancer radical operation.
【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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