加速康复外科在地市级医院腹腔镜胃癌根治术中的应用研究

Application of accelerated rehabilitation surgery in laparoscopic radical gastrectomy for gastric cancer

目的探讨加速康复外科在地市级医院腹腔镜胃癌根治术中的有效性及安全性。方法选取2016年3月—2019年12月焦作市第二人民医院普通外科收治的57例胃癌患者,其中加速康复组28例患者,传统治疗组29例患者,分别采用加速康复措施及传统治疗措施,比较两组患者的临床病理情况、术后恢复情况、并发症情况及炎症指标变化。结果和传统治疗组患者相比,加速康复组患者在胃管拔除时间、肛门排气时间、尿管拔除时间、首次进食时间、腹腔引流管拔除时间、术后住院时间均较短,住院花费较少,术后炎症指标较低,两组比较,差异有统计学意义(P<0.05)。结论加速康复外科在胃癌根治术患者中应用安全有效,可以促进患者康复。医生注重于提升医疗技术的同时,一定要重视与患者及家属的沟通,避免发生医疗纠纷。快速康复外科可以在有条件的中西部地区地市级医院逐步推广使用。

Objective To investigate the perioperative efficacy and safety of enhanced recovery after surgery in laparoscopic radical gastrectomy.Methods From March 2016 to December 2019,totally 57 gastric cancer patients were selected in the department of general surgery in the Second People’s Hospital of Jiaozuo city,enhanced recovery after surgery contained 28 patients and the traditional treatment group contained 29 patients.Those two group were treated with enhanced recovery after surgery measures and traditional treatment measures separately.Then several characteristics including clinical pathological conditions,postoperative recovery,complications and inflammation factors were compared between two groups.Results Compared with the traditional treatment group,the patients in the enhanced recovery after surgery group had shorter gastric tube removal time,anal exhaust time,urinary tube removal time,first feeding time,abdominal drainage tube removal time and postoperative hospital duration time.The enhanced recovery after surgery group also had less hospitalization costs and lower postoperative inflammatory factors(P<0.05).Conclusion The enhanced recovery after surgery is safe and effective in patients undergoing radical gastrectomy and can promote the recovery of patients.Doctors pay attention to improve medical technology at the same time,must attach importance to the patient and family communication,to avoid medical disputes.Rapid rehabilitative surgery can be gradually extended to municipal hospitals in Midwestern where conditions permit.