术前营养支持在腹腔镜右半结肠癌根治术快速康复治疗中的临床意义

发布时间：2018-06-24 23:31

本文选题：术前营养支持 + 快速康复外科　；参考：《中国微创外科杂志》2017年08期

【摘要】：目的探讨术前营养支持在腹腔镜右半结肠癌根治术后康复中的临床意义。方法回顾性分析2014年2月~2015年11月我科147例右半结肠癌的临床资料,其中68例接受快速康复治疗(fast track surgery,FTS),79例依我院常规执行围术期准备及处理,比较2组术后恢复情况及术后并发症等方面的差异。结果与常规组相比,FTS组在术后胃管留置时间[(1.6±0.6)d vs.(3.0±0.9)d,t=-10.565,P=0.000],腹腔引流管留置时间[(4.2±1.1)d vs.(9.3±2.3)d,t=-16.700,P=0.000],导尿管留置时间[(3.3±0.8)d vs.(3.7±1.0)d,t=-2.804,P=0.006],首次下地活动时间[(2.2±0.4)d vs.(2.5±0.6)d,t=-3.506,P=0.000],首次肛门排气时间[(3.4±0.9)d vs.(3.8±0.8)d,t=-2.853,P=0.002]以及术后住院时间[(8.6±2.7)d vs.(12.4±2.3)d,t=-9.369,P=0.000]明显缩短,而首次肛门排便时间无显著性差异[(4.5±1.1)d vs.(4.8±1.2)d,t=-1.570,P=0.059]。与常规组相比,FTS组术后非手术部位感染的发生率减少[1.5%(1/68)vs.11.4%(9/79),χ~2=4.217,P=0.040],而手术部位感染的发生率无显著差异[4.4%(3/68)vs.11.4%(9/79),χ~2=2.375,P=0.123]。结论基于FTS指南的术前营养支持减少了腹腔镜右半结肠癌根治术后非手术部位感染相关并发症,缩短术后住院时间,可使患者受益。
[Abstract]:Objective to investigate the clinical significance of preoperative nutritional support in the rehabilitation of laparoscopic right colon cancer. Methods the clinical data of 147 patients with right colon cancer from February 2014 to November 2015 were retrospectively analyzed. Among them, 68 cases received rapid rehabilitation therapy (fast track Surgeryus) and 79 cases were treated with routine perioperative preparation and management. The difference of postoperative recovery and postoperative complications between the two groups was compared. 缁撴灉涓庡父瑙勭粍鐩告瘮,FTS缁勫湪鏈悗鑳冪鐣欑疆鏃堕棿[(1.6卤0.6)d vs.(3.0卤0.9)d,t=-10.565,P=0.000],鑵硅厰寮曟祦绠＄暀缃椂闂碵(4.2卤1.1)d vs.(9.3卤2.3)d,t=-16.700,P=0.000],瀵煎翱绠＄暀缃椂闂碵(3.3卤0.8)d vs.(3.7卤1.0)d,t=-2.804,P=0.006],棣栨涓嬪湴娲诲姩鏃堕棿[(2.2卤0.4)d vs.(2.5卤0.6)d,t=-3.506,P=0.000],棣栨鑲涢棬鎺掓皵鏃堕棿[(3.4卤0.9)d vs.(3.8卤0.8)d,t=-2.853,P=0.002]浠ュ強鏈悗浣忛櫌鏃堕棿[(8.6卤2.7)d vs.(12.4卤2.3)d,t=-9.369,P=0.000]鏄庢樉缂╃煭, However, there was no significant difference in the first anal defecation time [(4.5 卤1.1) d vs. (, 4.8 卤1.2) dl ~ (-1.570), P ~ (0.059)]. Compared with the control group, the incidence of postoperative non-operative site infection in FTS group was decreased [1.5% (1 / 68) vs.11.4% (9 / 79), 蠂 ~ (2 / 2) 4.217p ~ (0.040)], but there was no significant difference [4.4% (3 / 68) vs.11.4% (9 / 79), 蠂 ~ (2 / 2) 2.375P ~ (0.123)]. Conclusion the preoperative nutritional support based on FTS guidelines can reduce the complications associated with non-operative site infection after laparoscopic radical resection of right colon cancer and shorten the postoperative hospitalization time, which can benefit the patients.
【作者单位】：厦门大学附属第一医院厦门市肿瘤医院胃肠肿瘤外科;厦门大学附属第一医院厦门市肿瘤医院麻醉手术科;
【分类号】：R735.35

【参考文献】