摘要
目的在改善患者临床结局的前提下，探讨快速康复外科对结直肠癌限期手术患者术后胰岛素敏感性的影响。方法2008年5-12月在中山大学附属第一医院就诊的70例拟接受开放限期手术的结直肠癌患者随机分为快速康复组和传统治疗组，每组35例，分别接受快速康复治疗及传统治疗，评价2组患者的临床指标、应激指标及胰岛素敏感性。结果共62例患者完成试验，其中快速康复组32例，传统治疗组30例。相对于传统治疗组，快速康复组患者术后胰岛素敏感性恢复快（术后第7天97％±9％，t=2．552，P=0．016），术后住院时间短（中位住院天数6d，Z=4．360，P=0．000），肠道功能恢复快（中位首次排气时间2d，Z=3．976，P=0．000），感染性并发症发生率低（2／32，P=0．040）。结论快速康复外科加速了结直肠癌限期手术患者术后胰岛素敏感性及术后肠道功能的恢复，降低了术后感染性并发症的发生率，缩短了术后住院时间。
Objective To investigate the effects of fast track surgery on postoperative insulin sensitivity on the basis of clinical benefits in patients undergoing elective open colorectal resection. Methods During May 2008 to December 2008, Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups： a fast track group （35 cases） and a conventional care group （35 cases）. All included patients received elective open colorectal resection with combined tracheal intubation and general anesthesia. Clinical parameters, stress markers and insulin sensitivity were evaluated in both groups. Results The 62 patients finally completed the study, 32 cases in the fast-track group and 30 cases in the conventional care group. The speed of recovery of postoperative insulin sensitivity on 7 days postoperative in the fast-track group （97% ±9% ） was significantly faster than the conventional care group （88.5% ±9. 0% , t = 2. 552, P = 0. 016）. The hospitalization days in the fast-track group was 6 days （ Ms0 ）, and it was significantly shorter than the conventional care group （ （ 11.7 ±3.8 ） days, Z = 4. 360, P = 0. 000）. The time of recovery of bowel function were faster in the fast-track group （ time to pass flatus was 2 days （M50）） than the conventional care group （4 days, Z = 3. 976, P = 0. 000）. The Infectious complication rate in the fast-track group （2/32） is lower than the other group （8/30, P = 0. 040） . Conclusion Fast track surgery accelerates recovery of postoperative insulin sensitivity in elective surgery for coloreetal carcinoma with a lower rate of postoperative infectious complications and a shorter length of postoperative hospital stay.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2012年第10期870-874,共5页
Chinese Journal of Surgery
关键词
结直肠癌
康复
胰岛素抗药性
随机对照试验
Colorectal neoplasms
Rehabilitation
Insulin resistance
Randomized controlled trial
