加速康复外科在腹腔镜结直肠癌手术中的应用效果
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摘要
目的探讨加速康复外科(ERAS)在腹腔镜结直肠癌手术中应用的安全性及有效性。方法选取2016年1月～2018年6月在我院行腹腔镜结直肠癌54例手术患者为加速康复组,应用ERAS治疗;选取2013年6月～2015年12月在我院行腹腔镜结直肠癌61例手术患者为对照组,应用传统方法治疗。对两组的术后首次排气时间、首次排便时间、半流食时间、停止补液时间、术后住院总天数及并发症发生率等进行比较。结果加速康复组术后肛门首次排气排便时间、半流食时间、停止补液时间、术后住院总天数明显短于对照组(P<0.05),加速康复组并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论 ERAS在腹腔镜结直肠癌手术中的应用是安全和有效的。
Objective To evaluate the safety and effectiveness of accelerated rehabilitation surgery(ERAS) in laparoscopic surgery of colorectal cancer. Methods From January 2016 to June 2018, 54 patients with laparoscopic colorectal cancer surgery were enrolled in ERAS as accelerated rehabilitation group; and 61 cases of laparoscopic surgery of colorectal cancer from June 2013 to December 2015 with traditional methods as the control group. First aerofluxus time,first dejection time, time to semi-liquid diet, time to stop infuse, length of stay postoperative and complication rate were compared between the two groups. Results In the accelerated rehabilitation group, the first anal exhaust defecation time, the half-feeding time, the stop rehydration time, and the postoperative hospital stay were significantly shorter than those of the control group(P<0.05). The total complication rate of the accelerated rehabilitation group was significantly lower than that of the control group. The difference was statistically significant(P<0.05). Conclusion The application of ERASin laparoscopic surgery of colorectal cancer is safe and effective.
Objective To evaluate the safety and effectiveness of accelerated rehabilitation surgery(ERAS) in laparoscopic surgery of colorectal cancer. Methods From January 2016 to June 2018, 54 patients with laparoscopic colorectal cancer surgery were enrolled in ERAS as accelerated rehabilitation group; and 61 cases of laparoscopic surgery of colorectal cancer from June 2013 to December 2015 with traditional methods as the control group. First aerofluxus time,first dejection time, time to semi-liquid diet, time to stop infuse, length of stay postoperative and complication rate were compared between the two groups. Results In the accelerated rehabilitation group, the first anal exhaust defecation time, the half-feeding time, the stop rehydration time, and the postoperative hospital stay were significantly shorter than those of the control group(P<0.05). The total complication rate of the accelerated rehabilitation group was significantly lower than that of the control group. The difference was statistically significant(P<0.05). Conclusion The application of ERASin laparoscopic surgery of colorectal cancer is safe and effective.
引文
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[12]花超,陈格亮,郑艳,等.肠内营养支持在结直肠癌患者快速康复手术中的实践与应用效果评价[J].世界临床药物,2016,37(8):528-530.
[13]Montgomery R,Mcnamara SA.Multimodal pain management for enhanced recovery:Reinforcing the shift from traditional pathways through nurse-led interventions[J].AORN J,2016,104(6):S9-S16.
[14]Chou R,Gordon DB,de Leon-Casasola OA,et al.Management of postoperative pain:a clinical practice guideline from the american pain society,the American society of regional anesthesia and pain medicine,and the american society of anesthesiologists′committee on regional anesthesia,executive committee,and administrative council[J].J Pain,2016,17(2):131-157.
[15]申乐,黄宇光.规范化术后多模式镇痛治疗对加速腹盆部手术后康复的意义[J].中国医学科学院学报,2016,38(4):458-463.
[2]李晓晖.经自然腔道取出标本手术联合加速康复外科理念在乙状结肠及直肠癌中的应用[J].现代医院,2018,18(10):1552-1554.
[3]Kehlet H,Slim K.The future of fast-track surgery[J].Br J Surg,2012,99(8):1025-1026.
[4]刘荫华,徐玲.《AJCC肿瘤分期手册》结直肠癌内容的更新与解读[J].中华胃肠外科杂志,2010,13(8):629-631.
[5]江志伟,李宁.结直肠手术应用加速康复外科中国专家共识(2015版)[J].中国实用外科杂志,2015,35(8):841-843.
[6]车国卫.加速肺康复外科临床实践及证据[J].中国肺癌杂志,2017,20(6):371-375.
[7]孔祥兴,李军,丁克峰.结直肠癌加速康复外科开展的要点和难点[J].中华胃肠外科杂志,2016,19(3):260-261.
[8]朱颖,安利杰,侯婧悦.快速康复外科研究进展[J].世界华人消化杂志,2017,25(34):3038-3045.
[9]郑志水,黄杰,林慧庆,等.快速康复外科理念对开胸肺切除术后应激状态的影响[J].实用医学杂志,2012,28(18):3095-3098.
[10]黎介寿.营养支持治疗与加速康复外科[J].肠外与肠内营养,2015,22(2):65-67.
[11]李盛国.结直肠肿瘤围手术期快速康复外科的应用研究[J].蛇志,2018,30(3):501-502.
[12]花超,陈格亮,郑艳,等.肠内营养支持在结直肠癌患者快速康复手术中的实践与应用效果评价[J].世界临床药物,2016,37(8):528-530.
[13]Montgomery R,Mcnamara SA.Multimodal pain management for enhanced recovery:Reinforcing the shift from traditional pathways through nurse-led interventions[J].AORN J,2016,104(6):S9-S16.
[14]Chou R,Gordon DB,de Leon-Casasola OA,et al.Management of postoperative pain:a clinical practice guideline from the american pain society,the American society of regional anesthesia and pain medicine,and the american society of anesthesiologists′committee on regional anesthesia,executive committee,and administrative council[J].J Pain,2016,17(2):131-157.
[15]申乐,黄宇光.规范化术后多模式镇痛治疗对加速腹盆部手术后康复的意义[J].中国医学科学院学报,2016,38(4):458-463.