摘要
目的探讨加速康复外科(enhanced recovery after surgery,ERAS)理念在胃癌根治术围手术期管理中应用的安全性、可行性。方法选择潍坊市人民医院胃肠外科2015年7月至2017年6月期间收治的57例实施D2根治术的进展期胃癌病人,随机分为ERAS组(28例)和传统组(29例),其中ERAS组选择ERAS的围手术期处理方案,传统组选择传统方案。结果ERAS组病人与传统组比较,术后住院天数减少[(7.17±2.00)d比(10.62±2.92)d,P=0.000],住院总费用减少[(50919.96±15589.13)元比(65920.93±17524.77)元,P=0.001],术后各时间点数字评分法(numerical rating scale,NRS)疼痛评分、术后各时间点的白细胞计数、C反应蛋白以及术后3d、5d的血清白蛋白等方面的数据均优于传统组,且差异均有统计学意义(P<0.05)。ERAS组病人术后并发症3例,传统组术后并发症4例,差异无统计学意义(P>0.05),均无围手术期死亡病例,随访1个月内均无再住院病例。结论ERAS理念在胃癌根治术围手术期管理中的应用是安全的、可行的。其具有更好临床效果,加速了病人康复进程。
Objective To investigate the safety and feasibility of the concept of enhanced recovery after surgery (ERAS) in the perioperative management of radical gastrectomy for gastric cancer. Methods A total of 57 patients with advanced gastric cancer who underwent D 2 radical gastrectomy from July 2015 to June 2017 were selected and randomly divided into ERAS group(28 cases) and traditional group(29 cases). Then the ERAS group were treated by ERAS management scheme in perioperative period, and the traditional group were treated by conventional scheme. Results Compared with the traditional group, the ERAS group was associated with less postoperative hospitalization days [( 7.17 ±2.00) d vs.(10.62±2.92) d, P =0.000]and lower total hospitalization expenses[( 50 919.96 ±15 589.13)yuan vs.(65 920.93±17 524.77)yuan, P =0.001]. The postoperative NRS (numerical rating scale) pain score, postoperative white blood cell count at each time point, C-reactive protein and postoperative serum albumin at 3 d and 5 d were superior to the traditional group, and the differences were statistically significant ( P <0.05). There were 3 cases of postoperative complications in ERAS group and 4 cases of postoperative complications in traditional group, and the difference had no statistical significance ( P >0.05), and both groups had no perioperative death case and no rehospitalization within 1 month of follow-up. Conclusion ERAS is safe and feasible in the perioperative management of radical gastrectomy for gastric cancer. It has a better clinical effect and can be used to accelerate the recovery process of patients.
作者
周瀚
延钊
石先慧子
于文胜
Zhou Han;Yan Zhao;Shi Xianhuizi(Department of Surgical Oncology,Anqiu People's Hospital, Shandong Weifang 262100,China;Department of Surgery, Weifang Medical University, Shandong Weifang 261053,China;Department of Gastrointestinal Surgery,Weifang People's Hospital, Shandong Weifang 261000,China)
出处
《腹部外科》
2019年第4期274-279,共6页
Journal of Abdominal Surgery
关键词
加速康复外科
胃肿瘤
胃癌根治术
围手术期管理
Enhanced recovery after surgery
Gastric cancer
Radical gastrectomy
Perioperative management
