摘要
目的:探讨采用快速康复外科(FTS)处理结肠癌手术患者的可行性。方法:40例结肠癌患者分为两组,每组20例,均行根治切除术。对照组予以常规处理;FTS组处理主要措施:详细术前教育;术前晚8点口服5%葡萄糖生理盐水1 000 mL,术晨6点静脉滴入10%葡萄糖液500 mL;全身麻醉复合硬膜外阻滞麻醉;不做不必要的大范围清除;术中保温;术后严格限制补液量;给予硬膜外镇痛;术后第1天停用抗生素并拔除胃肠减压管及导尿管、口服流质及下床活动;术后d2或d3拔除腹腔引流管等。比较两组术后口服固体食物时间、肠道功能、并发症及住院费用等情况。结果:与对照组相比,FTS组肠功能恢复时间缩短〔(46.6±7.3)hvs(73.4±6.9)h,P<0.05〕,术后进食固体食物较早〔(59.4±6.8)hvs(92.7±10.6)h,P<0.05〕,治疗费用减少约10.6%,并发症发生率差异无统计学意义(4/20vs5/20,P>0.05)。结论:结肠癌患者采用FTS措施安全可行,可促进患者康复,节省医疗资源。
OBJECTIVE：To investigate the feasibility of fast track surgery（FTS） in colon cancer resection.METHODS：Forty cases with radical resection for colon carcinoma were divided into two groups（n=20）.Control team was treated with routine methods.FTS group received managements as follows：detailed preoperative education,1 000 mL 5% GNS taken orally at 8 PM of preoperative night,500 mL 10% GS dripped intravenously at 6 AM of operation day,general anaesthesia combined with epidural block anaesthesia,appropriate dissection,incubation in operation,postoperative fluid bulk limited strictly,epidural analgesia,removal decompression tube of stomach and urethral catheter at first day after operation,liquid taken orally and out-of-bed activity at first morning after operation,no usage or removal drainage tube d2 or d3 after surgery.The time of solid diet taken orally and function of intestinal tract,complications and cost of hospitalization were compared between control and test teams.RESULTS：Compared with control team,FTS group cases presented earlier time of functional recovery of intestinal tract（（46.6±7.3） h vs（73.4±6.9） h,P0.05） and solid diet taken orally（（59.4±6.8） h vs（92.7±10.6） h,P0.05）,10.6% reduction of hospitalization cost and similar complication incidence rate（4/20 vs 5/20,P0.05）.CONCLUSION：FTS protocols are feasible for colon carcinoma operation,promote recovery from illness and save medical resource.
出处
《中华肿瘤防治杂志》
CAS
2010年第22期1868-1870,共3页
Chinese Journal of Cancer Prevention and Treatment
关键词
结肠肿瘤/外科学
康复/方法
围手术期
colonic neoplasms/surgery
rehabilitation/methods
peroperative period
