加速康复外科理念在胃癌根治术中应用安全性及可行性分析

发布时间：2018-10-26 21:56

【摘要】：目的观察加速康复外科(ERAS)理念在胃癌根治术中应用的安全性及可行性。方法回顾性分析广东省人民医院普外科胃肠专业组2015年7月至2016年1月收治的57例行D2根治手术的胃癌病人临床资料,根据围手术期是否应用ERAS理念处理分为ERAS组(21例)及传统组(36例)。结果 ERAS组与传统组相比,肛门排气时间提前[(2.95±1.36)d vs.(4.44±1.95)d,P=0.003],腹腔引流管留置数量及时间减少[(0.95±0.50)根vs.(2.03±0.45)根,P=0.000]、[(5.05±3.64)d vs.(8.69±5.40)d,P=0.008],术后经口进食时间提前[(1.71±2.39)d vs.(5.39±2.54)d,P=0.000],术后下床活动时间提前[(2.14±1.42)d vs.(3.47±1.80)d,P=0.005],术后住院时间缩短[(6.48±3.40)d vs.(10.56±6.54)d,P=0.010],住院费用减少[(68 270.57±13 277.11)元vs.(81 068.18±27187.35)元,P=0.021],术后疼痛减轻,两组病人术后6、12、24及48 h数字疼痛评分逐渐减少(P=0.001,0.000,0.000,0.000);两组术后并发症发生率为9.5%vs.11.1%(P=1.000),两组病人无围手术期死亡病例,术后1个月内均无再入院病例。结论胃癌根治术病人应用ERAS理念可以促进术后胃肠功能恢复,减轻术后疼痛,缩短住院时间,减轻经济负担。ERAS理念应用于胃癌根治术安全可行。
[Abstract]:Objective to observe the safety and feasibility of accelerated rehabilitation surgery (ERAS) in radical gastrectomy of gastric cancer. Methods the clinical data of 57 gastric cancer patients treated with D2 radical operation from July 2015 to January 2016 were analyzed retrospectively. The patients were divided into ERAS group (21 cases) and traditional group (36 cases). Results the anus exhaust time in ERAS group was earlier than that in traditional group [(2.95 卤1.36) d vs. (4.44 卤1.95) dp 0.003]. The number and time of celiac drainage tube indwelling decreased [(0.95 卤0.50) root vs., (2.03 卤0.45) root, (5.05 卤3.64) d vs. (卤8.69 卤5.40) dP0. 008]. The time of oral feeding was earlier [(1.71 卤2.39) d vs. (卤2.54) dP0. 000] and the time of getting out of bed was earlier [(2. 14 卤1. 42) d vs. (3. 47 卤1. 80) dP0. 005], and the postoperative time of getting out of bed was (2. 14 卤1. 42) d vs. (3. 47 卤1. 80) dP0. 005. The postoperative hospitalization time was shortened [(6.48 卤3.40) d vs. () 10.56 卤6.54], the hospitalization cost was reduced [(68 270.57 卤13 277.11) yuan vs. (81 068.18 卤27187.35) yuan, P < 0.021], the postoperative pain was alleviated. The digital pain scores of the two groups gradually decreased at 6: 12 and 48 hours after operation (P0. 001 / 0. 000 ~ 0. 000 ~ 0. 000 ~ 0. 000). The incidence of postoperative complications in the two groups was 9.5 / vs.11.1% (P = 1.000). There were no perioperative death cases in both groups and no readmission within one month after operation. Conclusion the application of ERAS in radical gastrectomy can promote the recovery of gastrointestinal function, relieve postoperative pain, shorten the hospital stay and reduce the economic burden. ERAS is safe and feasible in the radical gastrectomy of gastric cancer.
【作者单位】：广东省人民医院(广东省医学科学院)普外科胃肠专业组;汕头大学;南方医科大学;邵阳市中心医院胃肠外科;
【基金】：广东省医学科研基金项目(No.A2016532) 广东省科技计划项目(No.2016A020215128) 广东省自然科学基金项目(No.2016A030313762,No.2016A030310328)
【分类号】：R735.2

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