摘要
目的探究加速康复外科理念在腹腔镜胃癌根治术患者中的临床应用效果,为临床医师选择合理的治疗方案提供参考。方法选取2017年6月至2019年2月期间在辽宁省健康产业集团铁煤总医院接受腹腔镜胃癌根治术治疗的患者78例作为研究对象,对研究对象进行随机编号,按照抽签法分为对照组(39例,采用传统围手术期理念)和试验组(39例,应用加速康复外科理念)。比较两组患者的并发症发生率、术前1 d和术后5 d营养指标和应激指标、术后1、5 d疼痛程度。结果试验组患者并发症发生率为2.56%,显著低于对照组的15.38%(P<0.05)。两组患者术前1 d的血清白蛋白(ALB)、前白蛋白(PA)、C反应蛋白(CRP)水平比较,差异无统计学意义(P>0.05);两组患者术后5 d的ALB、PA水平均较术前1 d明显升高、CRP水平均较术前1 d明显降低,且试验组患者术后5 d的ALB、PA水平更高、CRP水平更低(P<0.05)。两组患者术后1 d的视觉模拟评分法(VAS)评分比较差异无统计学意义(P>0.05);两组患者术后5 d的VAS评分均较术后1 d降低,且试验组患者术后5 d的VAS评分较对照组更低(P<0.05)。结论在腹腔镜胃癌根治术中应用加速康复外科理念更有利于改善患者的营养指标,且对患者的应激性刺激较小,促进患者预后恢复。
Objective To explore the clinical application effect of the concept of accelerated rehabilitation surgery in patients undergoing laparoscopic radical gastrectomy for gastric cancer,and to provide reference for clinicians in choosing reasonable treatment options.Methods 78 patients who received laparoscopic radical gastrectomy for gastric cancer from June 2017 to February 2019 in Tiemei General Hospital of Liaoning Health Industry Group were selected as the research objects.According to the lottery method,they were divided into control group(39 cases,using traditional perioperative concept)and experimental group(39 cases,using accelerated rehabilitation surgery concept).The complication rate,nutritional indicators and stress indicators at 1 day before operation and 5 days after operation,and the degree of pain on the 1st and 5th day after operation were compared between the two groups.Results The incidence of complications in the experimental group was 2.56%,which was significantly lower than 15.38%in the control group(P<0.05).There was no significant difference in the levels of serum albumin(ALB),prealbumin(PA),and C-reactive protein(CRP)1 day before operation between the two groups of patients(P>0.05).The levels of ALB and PA were significantly higher than those of 1 d before operation,and the CRP levels were significantly lower than those of 1 d before operation.In addition,patients in the experimental group had higher ALB and PA levels and lower CRP levels at 5 d after operation(P<0.05).There was no significant difference in the visual analogue scoring(VAS)scores of the two groups of patients at 1 day after operation(P>0.05);the VAS scores of the two groups of patients at 5 days after operation were lower than those at 1 day after operation,and the VAS scores of patients in the experimental group on the 5th day after operation was lower than that of the control group(P<0.05).Conclusion The application of the concept of accelerated rehabilitation surgery in patients undergoing laparoscopic radical gastric cance
作者
徐铭
XU Ming(Department of General Surgery,Tiemei General Hospital of Liaoning Health Industry Group,Diaobingshan 112700,China)
出处
《中国医药指南》
2020年第25期13-15,共3页
Guide of China Medicine
关键词
腹腔镜
胃癌根治术
传统围手术期理念
加速康复外科理念
疼痛
并发症
Laparoscopy
Radical gastrectomy for gastric cancer
Traditional perioperative concept
Accelerated rehabilitation surgery concept
Pain
Complication
