摘要
目的探究与分析快速康复外科(FTS)理念对腹腔镜胃癌根治术患者术后康复及围术期应激指标的影响。方法选取哈尔滨医科大学附属第一医院2017年6月-2019年6月收治的腹腔镜胃癌根治术患者82例作为研究对象,采取随机数字表法将其分为对照组与观察组,每组各41例。对照组给予常规围术期管理,观察组在对照组基础上实施FTS理念围术期管理。比较两组患者手术相关指标(手术时间、术中出血量、淋巴结清扫数量、留置引流管的数量以及术中补液量)、术后康复相关指标(肛门排气时间、拔除尿管时间、经口进食时间以及住院时间)、围术期应激指标[术前,术后第1、4、7天患者的C反应蛋白(CRP)及白介素-6(IL-6)]以及并发症发生率。结果两组患者手术时间、术中出血量、淋巴结清扫数量比较,差异均无统计学意义(均P>0.05)。与对照组比较,观察组留置引流管的数量及术中补液量均较少(均P<0.01),观察组肛门排气时间、拔除尿管时间、经口进食时间以及住院时间均更短(均P<0.01)。与术前比较,两组CRP、IL-6水平在术后第1、4、7天的水平均明显升高(均P<0.05);观察组在术后第1、4、7天的CRP及IL-6水平均明显低于对照组(均P<0.05)。与对照组比较,观察组吻合口瘘、感染、胃潴留、肠梗阻及术后出血并发症发生率均较低(均P<0.05)。结论在常规围术期管理的基础上实施FTS理念应用于腹腔镜胃癌根治术中能够有效地促进患者术后的康复、改善围术期应激指标,且能降低并发症发生率,更好地确保了安全性。
Objective To explore and analyze the effect of fast track surgery(FTS)concept on postoperative rehabilitation and perioperative stress indicators in patients undergoing laparoscopic radical gastrectomy.Methods A total of 82 patients undergoing laparoscopic radical gastrectomy admitted to the First Affiliated Hospital of Harbin Medical University from June 2017 to June 2019 were selected as the research objects.A random number table method was used to divide them into the control group and observation group,each with 41 cases.The control group was given routine perioperative management,and the observation group was giren group perioperative management based on the concept of FTS on the basis of the control group.The surgical indicators(operating time,intraoperative blood loss,number of lymph node dissections,number of indwelling drainage tubes and intraoperative fluid replenishment),postoperative rehabilitation related indicators(anal exhaust time,urinary tube removal time,oral feeding time and the length of hospital stay),perioperative stress indicators[C-reactive protein(CRP)and interleukin-6(IL-6)before operation and on the first,fourth,and seventh days after operation]and complication rate were compared between the two groups.Results There were no significant differences in the operation time,intraoperative blood loss,and number of lymph node dissection between the two groups(all P>0.05).Compared with the control group,the number of indwelling drainage tubes and the amount of intraoperative fluid replacement in the observation group were less(all P<0.01).In the observation group,the time of anal exhaust,the time of removing the urinary tube,the time of oral feeding and the length of hospital stay were shorter(all P<0.01).Compared with preoperation,the levels of CRP and IL-6 in the two groups increased significantly on the first,fourth,and seventh days after operation(all P<0.05).The levels of CRP and IL-6 in the observation group were significantly lower than those in the control group(all P<0.05).Compared wit
作者
李斯博
黄澜
LI Sibo;HUANG Lan(Department of Tumor Laparoscopic Surgery,the First Affiliated Hospital of Harbin Medical University,Heilongjiang Province,Harbin150001,China)
出处
《中国医药导报》
CAS
2021年第2期90-93,97,共5页
China Medical Herald
基金
黑龙江省卫生计生委科研课题(2018450)。
关键词
快速康复外科理念
腹腔镜胃癌根治术
康复
围术期
应激指标
Fast track surgery concept
Laparoscopic radical gastrectomy
Rehabilitation
Perioperative period
Stress index
