摘要
目的探索快速流程模式对大肠癌手术患者术后恢复和近期生存质量的影响。方法前瞻性研究了四川大学华西医院胃肠外科中心2008年10月至2009年1月收治的符合条件患者122例,完成最终研究的患者121例。分为快速流程组(62例)和传统流程组(59例),比较其术后康复情况和术后1周时的生存质量核心问卷(QLQ-C30)评分。结果快速流程组较传统流程组术后排气时间更早〔(3.96±1.40)d vs.(5.66±3.11)d,P<0.05〕,首次进食更早〔(3.12±1.93)d vs.(5.96±3.23)d,P<0.05〕,首次下床活动时间更早〔(2.05±1.16)dvs.(5.13±1.36)d,P<0.05〕,术后住院时间更短〔(7.85±5.31)d vs.(10.11±3.37)d,P<0.05〕。同时,快速流程组术后切口感染和肠梗阻发生率低于传统流程组(1.61%vs.6.78%,P<0.05,1.61%vs.8.47%,P<0.05)。C30评分快速流程组的总体健康状况较优(80.46±15.54 vs.76.58±15.28,P<0.05)。C30功能量表评估中,快速流程组的躯体功能(87.35±5.12 vs.85.02±8.70,P<0.05)和情绪功能(90.00±0.00 vs.85.35±12.39,P<0.05)较优。症状量表评估中,快速流程组的疲倦症状(71.70±2.86 vs.87.12±10.80,P<0.05)和疼痛症状(71.78±3.76 vs.77.63±8.33,P<0.05)较轻。睡眠状态较优(75.78±11.68 vs.82.70±19.40,P<0.05),食欲丧失的状态较轻(73.24±8.60 vs.78.02±16.42,P<0.05)。结论快速流程模式加快了术后大肠癌患者的恢复,能提高生存质量。
Objective To explore the impact of postoperative recovery and short term quality of life in the patients with colorectal cancer in fast track model.Methods There were 122 patients enrolled into this prospective study in Gastrointestinal Surgery Center,West China Hospital of Sichuan University,from October 2008 to January 2009,and 121 patients completed the whole study.The patients were divided into the fast track group（62 cases） and the tradition track group（59 cases）,postoperative recovery and the QLQ-C30 scores were evaluated at one week after the surgery.Results The fast track group showed earlier recovery than the tradition group in first aerofluxus（（3.96±1.40） d vs.（5.66±3.11） d,P〈0.05）,first intake（（3.12±1.93） d vs.（5.96±3.23） d,P0.05）,first ambulation（（2.05±1.16） d vs.（5.13±1.36） d,P〈0.05） and in-hospital time post-operation（（7.85±5.31） d vs.（10.11±3.37） d,P〈0.05）.The incidence of wound infection（1.61% vs.6.78%,P〈0.05） and intestinal obstruction（1.61% vs.8.47%, P〈0.05） in fast track were significantly lower than those in the traditional track group.The general health of fast track in C30 is better too（80.46±15.54 vs.76.58±15.28,P〈0.05）.In the functional assessment of C30,the physical function（87.35±5.12 vs.85.02±8.70,P0.05） and emotional function（90.00±0.00 vs.85.35±12.39,P〈0.05） both were better in the fast track group.In the symptom assessment of C30,fast track group is less fatigue（71.70±2.86 vs.87.12±10.80,P〈0.05） and pain（71.78±3.76 vs.77.63±8.33,P〈0.05）.Better sleep（75.78±11.68 vs.82.70±19.40,P〈0.05） and less loss of appetite（73.24±8.60 vs.78.02±16.42,P〈0.05） were found in fast track group.Conclusion The fast track group manifested faster in postoperative recovery and can improve the quality of life in postoperative patients with colorectal cancer.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2010年第3期509-512,共4页
Journal of Sichuan University(Medical Sciences)
基金
四川省卫生厅科学研究项目(批准号090353)资助
