加速康复外科模式联合腹腔镜胃癌根治术治疗老年进展期胃癌的临床研究

发布时间：2018-05-04 19:02

本文选题：加速康复外科 + 腹腔镜　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:探讨加速康复外科联合腹腔镜胃癌根治术治疗老年进展期胃癌患者的安全性和临床效果。方法:将76例老年进展期胃癌患者,根据围手术期处理模式的不同分为两组,即ERAS+LAG组(给予加速康复外科模式处理,共42例)和LAG组(给予传统模式处理,共34例)。记录本研究所需各项临床指标,包括年龄、性别、肿瘤部位和大小、TNM分期和手术切除范围;手术时间、术中出血量、淋巴结清扫数目;首次排气时间、住院时间、住院费用、并发症发生情况;术后前三天疼痛评分(数字评分量表法);并随访4周。结果:1.两组患者在年龄、性别、肿瘤大小和位置、TNM分期和手术切除范围方面的差异无统计学意义(均P0.05)。2.两组患者在手术时间、术中出血量、淋巴结清扫数目方面的差别无统计学意义(均P0.05)。3.ERAS+LAG组术后肠道功能恢复快于对照组[(65.50±9.17)h vs.(79.08±9.06)h,P0.05],住院时间短于对照组[(14.30±4.00)d vs.(18.08±4.08)d,P0.05],住院费用低于对照组[(5.41±0.75)d vs.(6.80±0.69)d,P0.05];ERAS+LAG组术后镇痛效果好(P0.05)。两组患者术后并发症发生率方面的差异无统计学意义(11.63%vs.12.73%,χ2=0.000,P=0.985)。结论:加速康复外科联合腹腔镜胃癌根治术治疗老年进展期胃癌安全、有效,且优势明显。
[Abstract]:Objective: to investigate the safety and clinical effect of accelerated rehabilitation surgery combined with laparoscopic radical gastrectomy for elderly patients with advanced gastric cancer. Methods: 76 elderly patients with advanced gastric cancer were divided into two groups according to different perioperative management models: ERAS LAG group (42 cases treated by accelerated rehabilitation surgery) and LAG group (34 cases treated by traditional mode). To record the clinical parameters of the study, including age, sex, tumor location and size, TNM staging and surgical resection range; operative time, intraoperative bleeding volume, number of lymph nodes dissection, first exhaust time, hospitalization time, hospitalization cost, The incidence of complications, the pain score in the first three days after operation (digital score scale), and follow-up for 4 weeks. The result is 1: 1. There was no significant difference in age, sex, tumor size and location between the two groups in TNM staging and surgical resection range (all P 0.05. 2). The time of operation and the amount of blood lost during operation were observed in both groups. There was no significant difference in the number of lymph node dissection in P0.05).3.ERAS LAG group (the recovery of intestinal function in P0.05).3.ERAS LAG group was faster than that in control group [65.50 卤9.17 h vs.(79.08 卤9.06 h P 0.05], the hospitalization time was shorter than that in control group [14.30 卤4.00 d vs.(18.08 卤4.08 d P 0.05], and the cost of hospitalization was lower than that in control group (5.41 卤0.75 d vs.(6.80 卤0.69 d P 0.05). There was no significant difference in the incidence of postoperative complications between the two groups. Conclusion: accelerated rehabilitation surgery combined with laparoscopic radical gastrectomy is safe, effective and superior in the treatment of advanced gastric cancer in the elderly.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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