摘要
目的比较传统模式(TC)与快速流程模式(FT)对不同手术方式下的结直肠癌患者围术期的影响。方法选择2011年8月—2012年8月期间入住金华市中心医院的结直肠癌患者100例,按照随机分组的方法分为快速流程模式(FT)组与传统模式(TC)组,比较2组患者在基线资料(包括性别构成、平均年龄、TNM分期、分化程度、组织学类型、肿瘤位置、内科并发症发生率以及ASA分级等方面)、手术情况(包括手术名称、手术时间以及术中出血情况等)以及术后早期恢复情况(观察指标包括术后住院时间、首次经口进食时间以及并发症、监督各项FT环节等)方面的差异。结果①FT组与TC组在性别构成、平均年龄、TNM分期、分化程度、组织学类型、肿瘤位置、内科并发症发生率以及ASA分级等方面相比,差异无统计学意义(P>0.05)。②FT组与TC组在手术类型的构成比、手术时间方面相比,差异无统计学意义(P>0.05),但是2组在术中出血量方面,差异具有统计学意义(P<0.05)。③FT组患者首次下床时间、首次经口进食时间、首次排气时间、术后住院时间均明显小于TC组,2组相比差异具有统计学意义(P<0.05);2组术后2周病死率及再入院率均为0;FT组并发症总发生率明显小于TC组,2组相比,差异具有统计学意义(P<0.05),但是2组一般并发症与手术并发症发生率相比,差异无统计学意义(P>0.05)。结论快速流程模式(FT)能够促进不同手术方式下的结直肠癌患者的早期康复,有效降低并发症的发生率,缩短患者住院时间,且能够随着FT环节完成度的不断增加而取得更加显著的临床疗效,值得在临床上加以推广并应用。
Objective To compare the effects of perioperative traditional care（TC） and quick-track（FT） care on patients undergoing colorectal cancer surgery. Methods Between August 2011 and August 2012,100 patients with colorectal cancer were selected in our hospital and were randomly divided into the traditional care （TC） group and fast-track （FT） perioperative care program group. The baseline data（ including gender composition, average ages, TNM staging, differentia- tion degree, histological type, tumor location, the incidence of complication and ASA grading）, surgery status （ including the type of surgery, duration and bleeding during operation） and recovery status at early stage after operation （ including the length of stay in hospital after surgery, time for dieting through mouth for the first time, complication） were compared between FT and TC group. Results ①There was no statistical significance in baseline data between FT group and TC group（ P 〉 0.05 ）. ②There was statistical significance in the bleeding volume during the operation（ P 〈 0.05 ）, but not in the constituent ratio and duration of operation（ P 〉 0.05 ） between the two groups. ③The time in bed, time for dieting through mouth for the first time, exhaust time for the first time and hospital stay in FT group were obviously shorter than those of the TC group（P 〈 0. 05 ）. The case fatality ratios and readmission ratios of both groups were zero 2 weeks after surgery. The total incidence of complications in FT group was lower than that in TC group, with statistical significance （ P 〈 0. 05 ）. However, there were no differences between the common complications and operative complications （ P 〉 0. 05）. Conclusion FT can promote the early rehabilitation of patients undergoing colorectal cancer surgery, reduce effec- tively the incidence of complications, shorten in-hospital time, and achieve more remarkable clinical curative effect with the procedure of FT, it is worth in clinical promotion and
出处
《中华全科医学》
2014年第6期847-849,910,共4页
Chinese Journal of General Practice
基金
浙江省自然科学基金资助项目(201223212)
